0001209191-20-048646.txt : 20200828 0001209191-20-048646.hdr.sgml : 20200828 20200828165214 ACCESSION NUMBER: 0001209191-20-048646 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20200820 FILED AS OF DATE: 20200828 DATE AS OF CHANGE: 20200828 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HEADEN CYNTHIA A CENTRAL INDEX KEY: 0001821840 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32242 FILM NUMBER: 201148494 MAIL ADDRESS: STREET 1: 30 FRANK LLOYD WRIGHT DR CITY: ANN ARBOR STATE: MI ZIP: 48105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DOMINOS PIZZA INC CENTRAL INDEX KEY: 0001286681 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-GROCERIES & RELATED PRODUCTS [5140] IRS NUMBER: 382511577 FISCAL YEAR END: 1229 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 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2020-08-20 0 0001286681 DOMINOS PIZZA INC DPZ 0001821840 HEADEN CYNTHIA A 30 FRANK LLOYD WRIGHT DR ANN ARBOR MI 48105 0 1 0 0 EVP, Supply Chain Services Common Stock, $0.01 par value 2522.342 D Common Stock, $0.01 par value 22.368 I Owned by spouse Option to Purchase Common Stock 212.52 2021-07-19 2027-07-19 Common Stock, $0.01 par value 515 D Option to Purchase Common Stock 283.68 2022-07-18 2028-07-18 Common Stock, $0.01 par value 900 D Option to Purchase Common Stock 275.35 2023-07-10 2029-07-10 Common Stock, $0.01 par value 520 D Option to Purchase Common Stock 413.68 2024-07-15 2030-07-15 Common Stock, $0.01 par value 580 D Option to Purchase Common Stock 413.68 2024-07-15 2030-07-15 Common Stock, $0.01 par value 180 D Option to Purchase Common Stock 418.33 2024-08-20 2030-08-20 Common Stock, $0.01 par value 500 D Includes 145 shares of common stock representing the final tranche of an original grant of performance-based restricted stock that shall vest on July 19, 2021 if applicable performance conditions are achieved. Includes 230 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 18, 2021 and July 18, 2022 if applicable performance conditions are achieved. Includes 630 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 February 20, 2021, February 20, 2022 and February 20, 2023 if applicable performance conditions are achieved. Includes 278 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 July 10, 2021, July 10, 2022 and July 10, 2023 if applicable performance conditions are achieved. Includes 140 shares of common stock representing an original grant of performance-based restricted stock that shall vest one-fourth on each of July 15, 2021, July 15, 2022, July 15, 2023 and July 15, 2024 if applicable performance conditions are achieved. Includes 450 shares of common stock representing an original grant of performance-based restricted stock that shall vest one-fourth on each of July 15, 2021, July 15, 2022, July 15, 2023 and July 15, 2024 if applicable performance conditions are achieved. Includes 130 shares of common stock representing an original grant of performance-based restricted stock that shall vest one-fourth on each of August 20, 2021, August 20, 2022, August 20, 2023 and August 20, 2024 if applicable performance conditions are achieved. The number of underlying shares represents the unexercised portion of the original grant as of the date of this report. One-half of the unexercised options vested on July 19, 2020 and one-half shall vest on July 19, 2021. 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 18, 2019 and July 18, 2020 and one-fourth shall vest on each of July 18, 2021 and July 18, 2022. 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 10, 2020 and one-fourth shall vest on each of July 10, 2021, July 10, 2022 and July 10, 2023. 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, 2021, July 15, 2022, July 15, 2023 and July 15, 2024. 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 August 20, 2021, August 20, 2022, August 20, 2023 and August 20, 2024. /s/ Kevin S. Morris, attorney-in-fact 2020-08-28 EX-24.3_935317 2 poa.txt POA DOCUMENT POWER OF ATTORNEY Know all by these present, that the undersigned hereby constitutes and appoints Kevin S. Morris, Joseph W. Clementz and Stacey M. 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 16th day of August, 2020. /s/ Cynthia A. Headen Print: Cynthia A. Headen WITNESS: /s/ Kevin J. Parks Print: Kevin J. Parks