0001782487-19-000010.txt : 20191120
0001782487-19-000010.hdr.sgml : 20191120
20191120163455
ACCESSION NUMBER: 0001782487-19-000010
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191118
FILED AS OF DATE: 20191120
DATE AS OF CHANGE: 20191120
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: 191234626
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: 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_157428567882024.xml
FORM 4
X0306
4
2019-11-18
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
Restricted Stock Units
2019-11-18
4
A
0
10977
0
A
Common Stock
10977.0
10977
D
Each restricted stock unit represents a contingent right to receive one share of NVHI common stock.
The restricted stock units will vest in three installments, with 5,488 shares vesting on the second anniversary of the grant date, 2,744 shares vesting on the third anniversary of the grant date and 2,745 shares vesting on the fourth anniversary of the grant date.
/s/ Jared Brandman, as Attorney-in-Fact
2019-11-20