0001140361-17-040313.txt : 20171031
0001140361-17-040313.hdr.sgml : 20171031
20171031164323
ACCESSION NUMBER: 0001140361-17-040313
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171030
FILED AS OF DATE: 20171031
DATE AS OF CHANGE: 20171031
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Moore Patrick R.
CENTRAL INDEX KEY: 0001719844
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38257
FILM NUMBER: 171166199
MAIL ADDRESS:
STREET 1: C/O NATIONAL VISION HOLDINGS, INC.
STREET 2: 2435 COMMERCE AVENUE, BLDG. 2200
CITY: DULUTH
STATE: GA
ZIP: 30096
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: 1230
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
form4.xml
FORM 4
X0306
4
2017-10-30
0001710155
National Vision Holdings, Inc.
EYE
0001719844
Moore Patrick R.
C/O NATIONAL VISION HOLDINGS, INC.,
2435 COMMERCE AVENUE, BLDG. 2200
DULUTH
GA
30096-4980
true
SVP, Chief Financial Officer
Common Stock
2017-10-30
4
P
0
4500
22
A
47220
D
Reflects shares of common stock purchased under the Issuer's Directed Share Program in connection with the Issuer's initial public offering.
/s/ Jared Brandman, as Attorney-in-Fact
2017-10-31