0001795128-19-000009.txt : 20191211
0001795128-19-000009.hdr.sgml : 20191211
20191211164204
ACCESSION NUMBER: 0001795128-19-000009
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191209
FILED AS OF DATE: 20191211
DATE AS OF CHANGE: 20191211
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Blackwood Joan
CENTRAL INDEX KEY: 0001795128
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38257
FILM NUMBER: 191280168
MAIL ADDRESS:
STREET 1: C/O NATIONAL VISION HOLDINGS, INC.
STREET 2: 2435 COMMERCE AVE., BUILDING 2200
CITY: DULUTH
STATE: GA
ZIP: 30096
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_157610050753786.xml
FORM 4
X0306
4
2019-12-09
0
0001710155
National Vision Holdings, Inc.
EYE
0001795128
Blackwood Joan
C/O NATIONAL VISION HOLDINGS, INC.
2435 COMMERCE AVENUE, BLDG. 2200
DULUTH
GA
30096-4980
0
1
0
0
SVP, Chief Marketing Officer
Restricted Stock Units
2019-12-09
4
A
0
8230
0
A
Common Stock
8230.0
8230
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
2019-12-11