0001771515-24-000071.txt : 20240311
0001771515-24-000071.hdr.sgml : 20240311
20240311172144
ACCESSION NUMBER: 0001771515-24-000071
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240308
FILED AS OF DATE: 20240311
DATE AS OF CHANGE: 20240311
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bortner Andrea Renee
CENTRAL INDEX KEY: 0001808260
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38950
FILM NUMBER: 24739186
MAIL ADDRESS:
STREET 1: C/O GROCERY OUTLET HOLDING CORP.
STREET 2: 5650 HOLLIS STREET
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Grocery Outlet Holding Corp.
CENTRAL INDEX KEY: 0001771515
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-GROCERY STORES [5411]
ORGANIZATION NAME: 07 Trade & Services
IRS NUMBER: 471874201
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1228
BUSINESS ADDRESS:
STREET 1: 5650 HOLLIS STREET
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
BUSINESS PHONE: (510) 845-1999
MAIL ADDRESS:
STREET 1: 5650 HOLLIS STREET
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
4
1
wk-form4_1710192094.xml
FORM 4
X0508
4
2024-03-08
0
0001771515
Grocery Outlet Holding Corp.
GO
0001808260
Bortner Andrea Renee
C/O GROCERY OUTLET HOLDING CORP.
5650 HOLLIS STREET
EMERYVILLE
CA
94608
0
1
0
0
See Remarks
0
Common Stock
2024-03-08
4
S
0
5522
25.83
D
43786
D
Common Stock
22446
I
By Trust
These shares were sold to satisfy the reporting person's tax withholding obligation upon vesting of performance stock units previously granted.
Reflects shares directly held by the Bortner Family Trust of which Ms. Bortner is a Trustee.
EVP, Chief Human Resources Officer
/s/ Lauri Fischer, Lauri Fischer, attorney-in-fact
2024-03-11