0001209191-21-063380.txt : 20211108 0001209191-21-063380.hdr.sgml : 20211108 20211108161846 ACCESSION NUMBER: 0001209191-21-063380 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211104 FILED AS OF DATE: 20211108 DATE AS OF CHANGE: 20211108 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HEADEN CYNTHIA A CENTRAL INDEX KEY: 0001821840 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32242 FILM NUMBER: 211388230 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 STATE OF INCORPORATION: DE FISCAL YEAR END: 0102 BUSINESS ADDRESS: STREET 1: 30 FRANK LLOYD WRIGHT DRIVE CITY: ANN ARBOR STATE: MI ZIP: 48106 BUSINESS PHONE: (734) 930-3030 MAIL ADDRESS: STREET 1: 30 FRANK LLOYD WRIGHT DRIVE CITY: ANN ARBOR STATE: MI ZIP: 48106 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-11-04 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 2021-11-04 4 M 0 515 212.52 A 3464.218 D Common Stock, $0.01 par value 2021-11-04 4 S 0 515 500.00 D 2949.218 D Common Stock, $0.01 par value 2021-11-04 4 M 0 675 283.68 A 3624.218 D Common Stock, $0.01 par value 2021-11-04 4 S 0 675 500.00 D 2949.218 D Common Stock, $0.01 par value 2021-11-04 4 S 0 375 500.00 D 2574.218 D Common Stock, $0.01 par value 22.368 I Owned by spouse Option to Purchase Common Stock 212.52 2021-11-04 4 M 0 515 0.00 D 2021-07-19 2027-07-19 Common Stock, $0.01 par value 515 0 D Option to Purchase Common Stock 283.68 2021-11-04 4 M 0 675 0.00 D 2022-07-18 2028-07-18 Common Stock, $0.01 par value 675 225 D The transactions reported herein were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on October 19, 2021. /s/ Kevin S. Morris, attorney-in-fact 2021-11-08