0001719844-19-000008.txt : 20191219 0001719844-19-000008.hdr.sgml : 20191219 20191219163534 ACCESSION NUMBER: 0001719844-19-000008 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191217 FILED AS OF DATE: 20191219 DATE AS OF CHANGE: 20191219 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: 191296219 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: 1228 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_157679131484568.xml FORM 4 X0306 4 2019-12-17 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 2019-12-17 4 M 0 23 4.27 A 4523 D Common Stock 2019-12-17 4 S 0 23 32 D 4500 D Common Stock 2019-12-18 4 M 0 69977 4.27 A 74477 D Common Stock 2019-12-18 4 S 0 69977 32 D 4500 D Stock Option (Right to Buy) 4.27 2019-12-17 4 M 0 23 0 D 2024-09-16 Common Stock 23.0 128137 D Stock Option (Right to Buy) 4.27 2019-12-18 4 M 0 69977 0 D 2024-09-16 Common Stock 69977.0 58160 D The sale reported in this Form 4 was effected pursuant to a Rule 10b5-1 trading plan established by the reporting person on August 30, 2019. These stock options are fully vested. /s/ Jared Brandman, as Attorney-in-Fact 2019-12-19