0000899243-21-003634.txt : 20210128 0000899243-21-003634.hdr.sgml : 20210128 20210128175938 ACCESSION NUMBER: 0000899243-21-003634 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20210118 FILED AS OF DATE: 20210128 DATE AS OF CHANGE: 20210128 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MEJIA MARIA FERNANDA CENTRAL INDEX KEY: 0001673529 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38950 FILM NUMBER: 21567008 MAIL ADDRESS: STREET 1: ONE KELLOGG SQUARE STREET 2: PO BOX 3599 CITY: BATTLE CREEK STATE: MI ZIP: 49016-3599 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Grocery Outlet Holding Corp. CENTRAL INDEX KEY: 0001771515 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-GROCERY STORES [5411] IRS NUMBER: 471874201 STATE OF INCORPORATION: DE FISCAL YEAR END: 0102 BUSINESS ADDRESS: STREET 1: 5650 HOLLIS STREET CITY: EMERYVILLE STATE: CA ZIP: 94608 BUSINESS PHONE: (510) 845-1999 MAIL ADDRESS: STREET 1: 5650 HOLLIS STREET CITY: EMERYVILLE STATE: CA ZIP: 94608 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2021-01-18 1 0001771515 Grocery Outlet Holding Corp. GO 0001673529 MEJIA MARIA FERNANDA C/O GROCERY OUTLET HOLDING CORP. 5650 HOLLIS STREET EMERYVILLE CA 94608 1 0 0 0 Exhibit List: Exhibit 24 - Power of Attorney /s/ Pamela B. Burke, Pamela B. Burke, as Attorney-in-Fact 2021-01-28 EX-24 2 attachment1.htm EX-24 DOCUMENT

                               POWER OF ATTORNEY

Know all by  these presents that  the undersigned, does  hereby make, constitute
and appoint each of Aisha Barbeau, Pamela Burke and Lindsay Gray, or any one  of
them, as a true and lawful attorney-in-fact of the undersigned with full  powers
of substitution  and revocation,  for and  in the  name, place  and stead of the
undersigned (in the undersigned's  individual capacity), to execute  and deliver
such forms that the undersigned may be required to file with the U.S. Securities
and  Exchange  Commission as  a  result of  the  undersigned's ownership  of  or
transactions  in securities  of Grocery  Outlet Holding  Corp. (i)  pursuant to
Section 16(a)  of the  Securities Exchange  Act of  1934, as  amended, including
without limitation,  statements on  Form 3,  Form 4  and Form  5 (including  any
amendments  thereto) and  (ii) in  connection with  any applications  for EDGAR
access codes, including  without limitation the  Form ID. The  Power of Attorney
shall  remain  in full  force  and effect  until  the undersigned  is  no longer
required to file  Forms 3, 4  and 5 with  regard to his  or her ownership  of or
transactions  in  securities of  Grocery  Outlet Holding  Corp.,  unless earlier
revoked  in writing.  The undersigned  acknowledges that  Aisha Barbeau,  Pamela
Burke   and  Lindsay   Gray  are   not  assuming   any  of   the  undersigned's
responsibilities to  comply with  Section 16  of the  Securities Exchange Act of
1934, as amended.


                                        By:  /s/ Maria Fernanda Mejia
                                             -----------------------------------
                                        Name: Maria Fernanda Mejia

                                        Date: 01/26/2021