0001767639-22-000010.txt : 20220516 0001767639-22-000010.hdr.sgml : 20220516 20220516164741 ACCESSION NUMBER: 0001767639-22-000010 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220512 FILED AS OF DATE: 20220516 DATE AS OF CHANGE: 20220516 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Brandman Jared CENTRAL INDEX KEY: 0001767639 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38257 FILM NUMBER: 22930286 MAIL ADDRESS: STREET 1: C/O NATIONAL VISION HOLDINGS, INC. STREET 2: 2435 COMMERCE AVENUE BLDG. 2200 CITY: DULUTH STATE: GA ZIP: 30096-4980 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: 1231 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_165273402209791.xml FORM 4 X0306 4 2022-05-12 0 0001710155 National Vision Holdings, Inc. EYE 0001767639 Brandman Jared C/O NATIONAL VISION HOLDINGS, INC. 2435 COMMERCE AVENUE, BLDG. 2200 DULUTH GA 30096-4980 0 1 0 0 SVP, GC and Secretary Common Stock 2022-05-12 4 P 0 5000 23.245 A 18697 D /s/ Jared Brandman 2022-05-16