0001782487-19-000006.txt : 20190731 0001782487-19-000006.hdr.sgml : 20190731 20190731174800 ACCESSION NUMBER: 0001782487-19-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190729 FILED AS OF DATE: 20190731 DATE AS OF CHANGE: 20190731 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rasmussen Melissa CENTRAL INDEX KEY: 0001782487 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38257 FILM NUMBER: 19990025 MAIL ADDRESS: STREET 1: NATIONAL VISION HOLDINGS, INC. STREET 2: 2435 COMMERCE AVENUE BLDG 2200 CITY: DULUTH STATE: GA ZIP: 30095 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_156460966470849.xml FORM 4 X0306 4 2019-07-29 0 0001710155 National Vision Holdings, Inc. EYE 0001782487 Rasmussen Melissa C/O NATIONAL VISION HOLDINGS, INC. 2435 COMMERCE AVENUE, BLDG. 2200 DULUTH GA 30096-4980 0 1 0 0 SVP, Chief Accounting Officer Stock Option (Right to Buy) 11.63 2019-07-29 4 A 0 6879 11.63 A 2029-07-29 Common Stock 6879.0 6879 D These options vest in three equal installments beginning on July 29, 2020. /s/ Jared Brandman, as Attorney-in-Fact 2019-07-31