0001710155-22-000030.txt : 20220617 0001710155-22-000030.hdr.sgml : 20220617 20220617163530 ACCESSION NUMBER: 0001710155-22-000030 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220615 FILED AS OF DATE: 20220617 DATE AS OF CHANGE: 20220617 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Johnson Susan S CENTRAL INDEX KEY: 0001616181 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38257 FILM NUMBER: 221024415 MAIL ADDRESS: STREET 1: 303 PEACHTREE STREET, NE CITY: ATLANTA STATE: GA ZIP: 30308 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: National Vision Holdings, Inc. CENTRAL INDEX KEY: 0001710155 STANDARD INDUSTRIAL CLASSIFICATION: OPHTHALMIC GOODS [3851] IRS NUMBER: 464841717 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2435 COMMERCE AVENUE STREET 2: BLDG. 2200 CITY: DULUTH STATE: GA ZIP: 30096-4980 BUSINESS PHONE: (770) 822-3600 MAIL ADDRESS: STREET 1: 2435 COMMERCE AVENUE STREET 2: BLDG. 2200 CITY: DULUTH STATE: GA ZIP: 30096-4980 4 1 wf-form4_165549808550387.xml FORM 4 X0306 4 2022-06-15 0 0001710155 National Vision Holdings, Inc. EYE 0001616181 Johnson Susan S C/O NATIONAL VISION HOLDINGS, INC. 2435 COMMERCE AVENUE, BLDG 2200 DULUTH GA 30096 1 0 0 0 Common Stock 2022-06-15 4 A 0 7832 0 A 12261 D Represents a restricted stock unit ("RSU") grant pursuant to NVHI's non-employee director compensation policy. The RSUs vest in full on the one year anniversary of the date of grant, subject to the Reporting Person's continuous service through such vesting date. Each RSU represents a contingent right to receive one share of NVHI common stock. /s/ Jared Brandman, as Attorney-in-Fact 2022-06-17