0001104659-21-140159.txt : 20211116 0001104659-21-140159.hdr.sgml : 20211116 20211116195532 ACCESSION NUMBER: 0001104659-21-140159 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211112 FILED AS OF DATE: 20211116 DATE AS OF CHANGE: 20211116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Grijalva Laurie Marie CENTRAL INDEX KEY: 0001623311 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36711 FILM NUMBER: 211417967 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 tm2133085-1_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2021-11-12 0 0001610250 Boot Barn Holdings, Inc. BOOT 0001623311 Grijalva Laurie Marie C/O BOOT BARN HOLDINGS, INC. 15345 BARRANCA PKWY IRVINE CA 92618 0 1 0 0 Chief Merchandise Officer Common Stock 2021-11-12 4 M 0 13498 6.15 A 19235 D Common Stock 2021-11-12 4 S 0 13498 119.3311 D 5737 D Common Stock 12526 D Options 6.15 2021-11-12 4 M 0 13498 0 D 2025-06-05 Common Stock 13498 6749 D Reflects the weighted average price of sales on November 12, 2021. The shares were sold in multiple transactions at prices ranging from $119.0000 to $119.7900, inclusive. The reporting person undertakes to provide to Boot Barn Holdings, Inc., any security holder of Boot Barn Holdings, Inc., or the staff of the Securities Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within such range. Consists of the number of shares of common stock held by the reporting person as of November 16, 2021 that are not subject to further vesting. Consists of the number of shares of common stock underlying restricted stock units held by the reporting person as of November 16, 2021 that remain subject to time-based vesting. The Options were granted under the Company's 2014 Equity Incentive Plan and are subject to vesting over a five-year period in equal annual installments on each anniversary of the grant date. /s/ Laurie Marie Grijalva 2021-11-16