0001719844-18-000008.txt : 20181121 0001719844-18-000008.hdr.sgml : 20181121 20181121161733 ACCESSION NUMBER: 0001719844-18-000008 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181119 FILED AS OF DATE: 20181121 DATE AS OF CHANGE: 20181121 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: 181198388 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_154283503620963.xml FORM 4 X0306 4 2018-11-19 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 Stock Option (Right to Buy) 4.27 2018-11-19 4 A 0 36045 4.27 A 2024-09-16 Common Stock 36045.0 164205 D On September 16, 2014, the reporting person was granted stock options, subject to time-based and performance-based vesting. On November 19, 2018, a liquidity event with respect to such performance-based stock options occurred as a result of sales by the Issuer's sponsor stockholders and 36,045 stock options which had previously not been reported were deemed earned. Of the 164,205 stock options reported herein, 142,845 are vested and the remaining 21,360 time-based stock options will vest on March 13, 2019. An additional 60,076 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 2018-11-21