0001782487-22-000006.txt : 20220304
0001782487-22-000006.hdr.sgml : 20220304
20220304164741
ACCESSION NUMBER: 0001782487-22-000006
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220302
FILED AS OF DATE: 20220304
DATE AS OF CHANGE: 20220304
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: 22714819
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: 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_164643042410815.xml
FORM 4
X0306
4
2022-03-02
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
2022-03-02
4
A
0
4594
0
A
Common Stock
4594.0
11425
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 equal annual installments beginning on the first anniversary of the grant date.
/s/ Jared Brandman, as Attorney-in-Fact
2022-03-04