0001782487-24-000002.txt : 20240305 0001782487-24-000002.hdr.sgml : 20240305 20240305161338 ACCESSION NUMBER: 0001782487-24-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240301 FILED AS OF DATE: 20240305 DATE AS OF CHANGE: 20240305 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rasmussen Melissa CENTRAL INDEX KEY: 0001782487 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38257 FILM NUMBER: 24720514 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] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 464841717 STATE OF INCORPORATION: DE FISCAL YEAR END: 1230 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 wk-form4_1709673200.xml FORM 4 X0508 4 2024-03-01 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 Chief Financial Officer 0 Common Stock 2024-03-02 4 M 0 1531 A 16251 D Common Stock 2024-03-02 4 F 0 538 23.54 D 15713 D Common Stock 2024-03-03 4 M 0 6537 A 22250 D Common Stock 2024-03-03 4 F 0 2064 23.54 D 20186 D Restricted Stock Units 2024-03-01 4 A 0 10621 0 A Common Stock 10621 17479 D Restricted Stock Units 2024-03-02 4 M 0 1531 0 D Common Stock 1531 15948 D Restricted Stock Units 2024-03-03 4 M 0 6537 0 D Common Stock 6537 9411 D Restricted stock units convert into common stock on a one-for-one basis. Includes 123 shares acquired under the 2018 Associate Stock Purchase Plan. Reflects payment of tax liability by withholding securities incident to vesting of restricted stock units. One-third of these restricted stock units will vest on each anniversary of the grant date, March 1, 2024. Total holdings have been adjusted to reflect an inadvertent error in prior Form 4s. On March 2, 2022, the reporting person was granted 4,594 restricted stock units, which vest in three equal installments on each anniversary of the grant date. On March 3, 2023, the reporting person was granted 19,611 restricted stock units, which vest in three equal installments on each anniversary of the grant date. /s/ Jared Brandman, as Attorney-in-Fact 2024-03-05