0001795128-20-000004.txt : 20201211 0001795128-20-000004.hdr.sgml : 20201211 20201211162903 ACCESSION NUMBER: 0001795128-20-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201209 FILED AS OF DATE: 20201211 DATE AS OF CHANGE: 20201211 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: 201383825 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: 0102 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_160772213001641.xml FORM 4 X0306 4 2020-12-09 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 Common Stock 2020-12-09 4 M 0 2743 0 A 2743 D Common Stock 2020-12-09 4 F 0 1576 46.36 D 1167 D Restricted Stock Units 2020-12-09 4 M 0 2743 0 D Common Stock 2743.0 5487 D Each restricted stock unit represents a contingent right to receive one share of NVHI common stock. On December 9, 2019, the reporting person was granted 8,230 restricted stock units, vesting in three equal annual installments beginning on the first anniversary of the grant date. /s/ Jared Brandman as Attorney-in-Fact 2020-12-11