0001104659-21-143749.txt : 20211124 0001104659-21-143749.hdr.sgml : 20211124 20211124200327 ACCESSION NUMBER: 0001104659-21-143749 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211122 FILED AS OF DATE: 20211124 DATE AS OF CHANGE: 20211124 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Conroy James Grant CENTRAL INDEX KEY: 0001623534 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36711 FILM NUMBER: 211448857 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 tm2133085-5_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2021-11-22 0 0001610250 Boot Barn Holdings, Inc. BOOT 0001623534 Conroy James Grant C/O BOOT BARN HOLDINGS, INC. 15345 BARRANCA PKWY IRVINE CA 92618 1 1 0 0 Chief Executive Officer Common Stock 2021-11-22 5 G 0 E 4000 0.00 D 10958 D Common Stock 42765 D On November 22, 2021, the reporting person made a charitable gift of 4,000 shares. Consists of the number of shares of common stock held by the reporting person as of November 24, 2021 that are not subject to further vesting conditions. Consists of the total number of shares of common stock underlying restricted stock units held by the reporting person as of November 24, 2021 that remain subject to time-based vesting. /s/ James Grant Conroy 2021-11-24