0001415889-22-009178.txt : 20220830 0001415889-22-009178.hdr.sgml : 20220830 20220830172007 ACCESSION NUMBER: 0001415889-22-009178 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220829 FILED AS OF DATE: 20220830 DATE AS OF CHANGE: 20220830 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BETTINELLI GREG CENTRAL INDEX KEY: 0001583198 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36711 FILM NUMBER: 221215420 MAIL ADDRESS: STREET 1: 4151 EAST 96TH STREET CITY: INDIANAPOLIS STATE: IN ZIP: 46240 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Boot Barn Holdings, Inc. CENTRAL INDEX KEY: 0001610250 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-SHOE STORES [5661] IRS NUMBER: 900776290 STATE OF INCORPORATION: DE FISCAL YEAR END: 0401 BUSINESS ADDRESS: STREET 1: 15345 BARRANCA PARKWAY CITY: IRVINE STATE: CA ZIP: 92618 BUSINESS PHONE: 949-453-4400 MAIL ADDRESS: STREET 1: 15345 BARRANCA PARKWAY CITY: IRVINE STATE: CA ZIP: 92618 4 1 form4-08302022_020855.xml X0306 4 2022-08-29 1 0001610250 Boot Barn Holdings, Inc. BOOT 0001583198 BETTINELLI GREG C/O BOOT BARN HOLDINGS, INC. 15345 BARRANCA PKWY IRVINE CA 92618 true false false false Common Stock 2022-08-29 4 D 0 1265 0 D 4859 D Such shares underlying restricted stock units were granted under the Company's 2020 Equity Incentive Plan on May 12, 2022 and were subject to vesting on the first anniversary of the date of grant. Mr. Bettinelli has served on the Company's Board of Directors since 2012 and did not stand for re-election at this year's Annual Meeting, which occurred on August 29, 2022. Accordingly, such restricted stock units have been forfeited. Amount of securities beneficially owned consists of the number of shares of common stock held by the reporting person as of August 29, 2022. /s/ Greg Bettinelli 2022-08-30