0001719844-20-000004.txt : 20201112 0001719844-20-000004.hdr.sgml : 20201112 20201112164221 ACCESSION NUMBER: 0001719844-20-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201109 FILED AS OF DATE: 20201112 DATE AS OF CHANGE: 20201112 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: 201307455 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: 0102 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_160521732395209.xml FORM 4 X0306 4 2020-11-09 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 2020-11-09 4 M 0 58161 4.27 A 62661 D Common Stock 2020-11-09 4 S 0 58161 47.17 D 4500 D Stock Option (Right to Buy) 4.27 2020-11-09 4 M 0 58161 0 D 2024-09-16 Common Stock 58161.0 0 D Price represents the weighted average sales price. The shares were sold pursuant to a single order in multiple transactions as prices ranging from $47.06 to $47.64. 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. These options previously vested upon achievement of certain liquidity-event performance-based vesting conditions, as previously reported. /s/ Jared Brandman, as Attorney-in-Fact 2020-11-12