0001857010-22-000002.txt : 20220304 0001857010-22-000002.hdr.sgml : 20220304 20220304164204 ACCESSION NUMBER: 0001857010-22-000002 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: Francis Roger F. CENTRAL INDEX KEY: 0001857010 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38257 FILM NUMBER: 22714730 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_164643010095440.xml FORM 4 X0306 4 2022-03-02 0 0001710155 National Vision Holdings, Inc. EYE 0001857010 Francis Roger F. C/O NATIONAL VISION HOLDINGS, INC. 2435 COMMERCE AVENUE, BLDG 2200 DULUTH GA 30096 0 1 0 0 SVP, Chief Stores Officer Restricted Stock Units 2022-03-02 4 A 0 9187 0 A Common Stock 9187.0 12546 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