0001209191-15-068814.txt : 20150901
0001209191-15-068814.hdr.sgml : 20150901
20150901163702
ACCESSION NUMBER: 0001209191-15-068814
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20150828
FILED AS OF DATE: 20150901
DATE AS OF CHANGE: 20150901
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: DOMINOS PIZZA INC
CENTRAL INDEX KEY: 0001286681
STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-GROCERIES & RELATED PRODUCTS [5140]
IRS NUMBER: 382511577
BUSINESS ADDRESS:
STREET 1: 30 FRANK LLOYD WRIGHT DRIVE
CITY: ANN ARBOR
STATE: MI
ZIP: 48106
MAIL ADDRESS:
STREET 1: 30 FRANK LLOYD WRIGHT DRIVE
CITY: ANN ARBOR
STATE: MI
ZIP: 48106
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LAWRENCE JEFFREY D
CENTRAL INDEX KEY: 0001651480
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32242
FILM NUMBER: 151087710
MAIL ADDRESS:
STREET 1: 30 FRANK LLOYD WRIGHT DR
CITY: ANN ARBOR
STATE: MI
ZIP: 48105
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2015-08-28
0
0001286681
DOMINOS PIZZA INC
DPZ
0001651480
LAWRENCE JEFFREY D
30 FRANK LLOYD WRIGHT DR
ANN ARBOR
MI
48105
0
1
0
0
Chief Financial Officer
Common Stock, $0.01 par value
9541.478
D
Option to Purchase Common Stock
10.06
2012-07-18
2017-07-18
Common Stock, $0.01 par value
10800
D
Option to Purchase Common Stock
7.97
2012-07-16
2019-07-16
Common Stock, $0.01 par value
4000
D
Option to Purchase Common Stock
10.06
2012-07-18
2017-07-18
Common Stock, $0.01 par value
2700
D
Option to Purchase Common Stock
10.88
2013-07-16
2018-07-16
Common Stock, $0.01 par value
9600
D
Option to Purchase Common Stock
10.88
2013-07-16
2018-07-16
Common Stock, $0.01 par value
4000
D
Option to Purchase Common Stock
7.88
2013-07-16
2018-07-16
Common Stock, $0.01 par value
2400
D
Option to Purchase Common Stock
7.88
2013-07-16
2018-07-16
Common Stock, $0.01 par value
1000
D
Option to Purchase Common Stock
63.05
2017-07-17
2023-07-17
Common Stock, $0.01 par value
1470
D
Option to Purchase Common Stock
73.04
2018-07-16
2024-07-16
Common Stock, $0.01 par value
2630
D
Option to Purchase Common Stock
118.54
2019-07-15
2025-07-15
Common Stock, $0.01 par value
2060
D
Option to Purchase Common Stock
118.54
2019-07-15
2025-07-15
Common Stock, $0.01 par value
9070
D
Includes 823.345 shares acquired under the Domino's Employee Stock Payroll Deduction Plan.
Includes 890 shares of common stock representing two-fourths of an original grant of performance-based restricted stock that shall vest one-half on each of July 17, 2016 and July 17, 2017 if applicable performance conditions are achieved.
Includes 1,060 shares of common stock representing two-fourths of an original grant of performance-based restricted stock that shall vest one-half on each of February 27, 2016 and February 27, 2017 if applicable performance conditions are achieved.
Includes 1,133 shares of common stock representing three-fourths of an original grant of performance-based restricted stock that shall vest one-third on each of July 16, 2016, July 16, 2017 and July 16, 2018 if applicable performance conditions are achieved.
Includes 960 shares of common stock representing a grant of performance-based restricted stock that shall vest one-fourth on each of July 15, 2016, July 15, 2017, July 15, 2018 and July 15, 2019 if applicable performance conditions are achieved.
Includes 2,110 shares of common stock representing a grant of performance-based restricted stock that shall vest one-fourth on each of July 15, 2016, July 15, 2017, July 15, 2018 and July 15, 2019 if applicable performance conditions are achieved.
The options to purchase common stock vest one-fourth each year on the anniversary date of the grant date. Thus, one-fourth vested on each of July 17, 2014 and July 17, 2015, and one-fourth shall vest on each of July 17, 2016 and July 17, 2017.
The options to purchase common stock vest one-fourth each year on the anniversary date of the grant date. Thus, one-fourth vested on July 16, 2015, and one-fourth shall vest on each of July 16, 2016, July 16, 2017 and July 16, 2018.
The options to purchase common stock vest one-fourth each year on the anniversary date of the grant date. Thus, one-fourth shall vest on each of July 15, 2016, July 15, 2017, July 15, 2018 and July 15, 2019.
/s/ Adam J. Gacek, attorney-in-fact
2015-09-01
EX-24.3_603450
2
poa.txt
POA DOCUMENT
POWER OF ATTORNEY
Know all by these present, that the undersigned hereby constitutes
and appoints Adam Gacek and Stacey Rodriguez, signing singly, the undersigned's
true and lawful attorney-in-fact to:
(1) execute for and on behalf of the undersigned, in the undersigned's
capacity as an officer and/or director of Domino's Pizza, Inc. (the "Company"),
Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities Exchange
Act of 1934 and the rules thereunder;
(2) do and perform any and all acts for and on behalf of the undersigned
which may be necessary or desirable to complete and execute any such Form 3, 4,
or 5, complete and execute any amendment or amendments thereto, and timely file
such form with the United States Securities and Exchange Commission and any
stock exchange or similar authority; and
(3) take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of benefit to,
in the best interest of, or legally required by, the undersigned, it being
understood that the documents executed by such attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney shall be in such form and shall
contain such terms and conditions as such attorney-in-fact may approve in such
attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that such attorney-in-fact, or such
attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be
done by virtue of this power of attorney and the rights and powers herein
granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in
serving in such capacity at the request of the undersigned, are not assuming,
nor is the Company assuming, any of the undersigned's responsibilities to comply
with Section 16 of the Securities Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 28th day of August, 2015.
/s/ Jeffrey D. Lawrence
JEFFREY D. LAWRENCE