0001719844-18-000002.txt : 20180727 0001719844-18-000002.hdr.sgml : 20180727 20180727162850 ACCESSION NUMBER: 0001719844-18-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180725 FILED AS OF DATE: 20180727 DATE AS OF CHANGE: 20180727 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: 18975110 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 wf-form4_153272331492092.xml FORM 4 X0306 4 2018-07-25 0 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 0 1 0 0 SVP, Chief Financial Officer Common Stock 2018-07-25 4 M 0 9154 8.23 A 56374 D Stock Option (Right to Buy) 8.23 2018-07-25 4 M 0 9154 0 D 2024-09-16 Common Stock 9154.0 0 D Represents an exercise of stock options in connection with the Reporting Person's sale of shares of common stock received upon exercise in a secondary offering that is scheduled to be completed on July 30, 2018. These stock options are fully vested. /s/ Jared Brandman, as Attorney-in-Fact 2018-07-27