0001104659-21-133830.txt : 20211103
0001104659-21-133830.hdr.sgml : 20211103
20211103184723
ACCESSION NUMBER: 0001104659-21-133830
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211102
FILED AS OF DATE: 20211103
DATE AS OF CHANGE: 20211103
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Hackman Gregory V.
CENTRAL INDEX KEY: 0001633114
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36711
FILM NUMBER: 211377113
MAIL ADDRESS:
STREET 1: 15776 LAGUNA CANYON ROAD
CITY: IRVINE
STATE: CA
ZIP: 92618
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: 0326
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
tm2131623-3_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2021-11-02
0
0001610250
Boot Barn Holdings, Inc.
BOOT
0001633114
Hackman Gregory V.
C/O BOOT BARN HOLDINGS, INC.
15345 BARRANCA PKWY
IRVINE
CA
92618
0
1
0
0
EVP, COO
Common Stock
2021-11-02
5
G
0
E
128
0.00
D
29185
D
Common Stock
17932
D
Donation to a charitable organization.
Consists of the number of shares of common stock held by the reporting person as of November 02, 2021, but excluding any shares of common stock subject to further vesting conditions. See Note 3 below.
Consists of the total number of shares of common stock underlying restricted stock units held by the reporting person as of November 02, 2021, that remain subject to time-based vesting.
/s/ Gregory V. Hackman
2021-11-03