FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 02/19/2020 |
3. Issuer Name and Ticker or Trading Symbol
DOMINOS PIZZA INC [ DPZ ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock, $0.01 par value | 7,014.268(1)(2)(3)(4)(5) | D | |
Common Stock, $0.01 par value | 245.771 | I | 401(k) Savings Plan |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Option to Purchase Common Stock | 07/17/2017 | 07/17/2023 | Common Stock, $0.01 par value | 1,470 | $63.05 | D | |
Option to Purchase Common Stock | 07/16/2018 | 07/16/2024 | Common Stock, $0.01 par value | 2,010 | $73.04 | D | |
Option to Purchase Common Stock | 07/15/2019 | 07/15/2025 | Common Stock, $0.01 par value | 2,630 | $118.54 | D | |
Option to Purchase Common Stock | 07/20/2020(6) | 07/20/2026 | Common Stock, $0.01 par value | 3,100 | $136.89 | D | |
Option to Purchase Common Stock | 07/20/2020(6) | 07/20/2026 | Common Stock, $0.01 par value | 2,350 | $136.89 | D | |
Option to Purchase Common Stock | 11/07/2020(7) | 11/07/2026 | Common Stock, $0.01 par value | 4,870 | $168.21 | D | |
Option to Purchase Common Stock | 07/19/2021(8) | 07/19/2027 | Common Stock, $0.01 par value | 2,450 | $212.52 | D | |
Option to Purchase Common Stock | 04/09/2022(9) | 04/09/2018 | Common Stock, $0.01 par value | 3,620 | $232.43 | D | |
Option to Purchase Common Stock | 07/10/2023(10) | 07/10/2029 | Common Stock, $0.01 par value | 3,520 | $275.35 | D |
Explanation of Responses: |
1. Includes 279 shares of common stock representing the final tranche of an original grant of performance-based restricted stock that shall vest on July 20, 2020 if applicable performance conditions are achieved. |
2. Includes 299 shares of common stock representing the final tranche of an original grant of performance-based restricted stock that shall vest on November 7, 2020 if applicable performance conditions are achieved. |
3. Includes 416 shares of common stock representing the final two tranches of an original grant of performance-based restricted stock that shall vest one-half on each of July 19, 2020 and July 19, 2021 if applicable performance conditions are achieved. |
4. Includes 690 shares of common stock representing the final three tranches of an original grant of performance-based restricted stock that shall vest one-third on each of April 9, 2020, April 9, 2021 and April 9, 2022 if applicable performance conditions are achieved. |
5. Includes 840 shares of common stock representing a grant of performance-based restricted stock that shall vest one-fourth on each of July 10, 2020, July 10, 2021, July 10, 2022 and July 10, 2023 if applicable performance conditions are achieved. |
6. 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 20, 2017, July 20, 2018 and July 20, 2019 and one-fourth shall vest on July 20, 2020. |
7. 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 November 7, 2017, November 7, 2018 and November 7, 2019 and one-fourth shall vest on November 7, 2020. |
8. 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 19, 2018 and July 19, 2019 and one-fourth shall vest on each of July 19, 2020 and July 19, 2021. |
9. The options to purchase common stock vest one-fourth each year on the anniversary date of the grant date. Thus, one-fourth vested on April 9, 2019 and one-fourth shall vest on each of April 9, 2020, April 9, 2021 and April 9 2022. |
10. 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 10, 2020, July 10, 2021, July 10, 2022 and July 10, 2023. |
Remarks: |
/s/ Kevin S. Morris, attorney-in-fact | 02/28/2020 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |