0001804913-22-000006.txt : 20220318 0001804913-22-000006.hdr.sgml : 20220318 20220318163329 ACCESSION NUMBER: 0001804913-22-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220316 FILED AS OF DATE: 20220318 DATE AS OF CHANGE: 20220318 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Acharya Ravi CENTRAL INDEX KEY: 0001804913 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38257 FILM NUMBER: 22752995 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: 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_164763559284110.xml FORM 4 X0306 4 2022-03-16 0 0001710155 National Vision Holdings, Inc. EYE 0001804913 Acharya Ravi C/O NATIONAL VISION HOLDINGS, INC. 2435 COMMERCE AVENUE, BLDG. 2200 DULUTH GA 30096 0 1 0 0 SVP, Chief Technology Officer Common Stock 2022-03-16 4 M 0 896 0 A 1934 D Common Stock 2022-03-16 4 F 0 270 D 1664 D Restricted Stock Units 2022-03-16 4 M 0 896 0 D Common Stock 896.0 8409 D Each restricted stock unit represents a contingent right to receive one share of NVHI common stock. On March 16, 2022, 896 restricted stock units vested and 270 shares of the Company's common stock were withheld to satisfy tax withholding obligations. The closing price on March 16, 2022 of the Company's common stock on NASDAQ was $42.88 per share. On March 16, 2020, the reporting person was granted 2,689 restricted stock units, vesting in three equal installments beginning on the first anniversary of the grant date. /s/ Jared Brandman, as Attorney-in-Fact 2022-03-18