0001209191-22-010194.txt : 20220216
0001209191-22-010194.hdr.sgml : 20220216
20220216161921
ACCESSION NUMBER: 0001209191-22-010194
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220102
FILED AS OF DATE: 20220216
DATE AS OF CHANGE: 20220216
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ALLISON RICHARD E JR
CENTRAL INDEX KEY: 0001622500
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32242
FILM NUMBER: 22643809
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
5
1
doc5.xml
FORM 5 SUBMISSION
X0306
5
2022-01-02
0
0
0
0001286681
DOMINOS PIZZA INC
DPZ
0001622500
ALLISON RICHARD E JR
DOMINO'S PIZZA
30 FRANK LLOYD WRIGHT DRIVE
ANN ARBOR
MI
48105
1
1
0
0
Chief Executive Officer
Common Stock, $0.01 par value
2021-08-18
5
G
0
200
0.00
D
43672.926
D
Common Stock, $0.01 par value
2021-08-18
5
G
0
400
0.00
D
43272.926
D
Common Stock, $0.01 par value
250
I
Son
Common Stock, $0.01 par value
250
I
Daughter
This transaction involved a gift of common stock of Domino's Pizza, Inc. by the Reporting Person to a charitable organization. The transaction is exempt from Section 16(b) of the Securities Exchange Act of 1934, as amended (the "Act"), pursuant to Rule 16b-5 of the Act.
/s/ Kevin S. Morris, attorney-in-fact
2022-02-16