0001719312-19-000004.txt : 20190516 0001719312-19-000004.hdr.sgml : 20190516 20190516163120 ACCESSION NUMBER: 0001719312-19-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190514 FILED AS OF DATE: 20190516 DATE AS OF CHANGE: 20190516 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Beasley Chris CENTRAL INDEX KEY: 0001719312 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38257 FILM NUMBER: 19832660 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: 1229 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_155803866550614.xml FORM 4 X0306 4 2019-05-14 0 0001710155 National Vision Holdings, Inc. EYE 0001719312 Beasley Chris C/O NATIONAL VISION HOLDINGS, INC., 2435 COMMERCE AVENUE, BLDG. 2200 DULUTH GA 30096-4980 0 1 0 0 SVP, Accounting, & Controller Common Stock 2019-05-14 4 M 0 25000 5.25 A 25000 D Common Stock 2019-05-14 4 S 0 25000 26.988 D 0 D Stock Option (Right to Buy) 5.25 2019-05-14 4 M 0 25000 5.25 D 2025-09-01 Common Stock 25000.0 49818 D Price represents the weighted average sales price. The shares were sold pursuant to a single order in multiple transactions as prices ranging from $26.85 to $27.22. Upon request by the SEC staff, the issuer or a security holder of the issuer, the reporting person will provide full information regarding the number of shares sold at each separate price. Of these 49,818 stock options, 25,407 are vested and the remaining 24,411 stock options will vest in two equal annual installments on September 1, 2019 and 2020. An additional 34,329 stock options which remain subject to liquidity-event performance-based vesting conditions are not included in the table above. /s/ Jared Brandman, as Attorney-in-Fact 2019-05-16