0001719844-19-000004.txt : 20190814
0001719844-19-000004.hdr.sgml : 20190814
20190814163946
ACCESSION NUMBER: 0001719844-19-000004
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190812
FILED AS OF DATE: 20190814
DATE AS OF CHANGE: 20190814
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: 191027112
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_156581516975061.xml
FORM 4
X0306
4
2019-08-12
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
2019-08-12
4
A
0
28036
4.27
A
2024-09-16
Common Stock
28036.0
192241
D
On September 16, 2014, the reporting person was granted stock options, subject to time-based and performance-based vesting. On August 12, 2019, the final liquidity event with respect to such performance-based stock options occurred as a result of sales by the Issuer's sponsor stockholder and 28,036 stock options which had previously not been reported were deemed earned.
All of these stock options are vested.
/s/ Jared Brandman, as Attorney-in-Fact
2019-08-14