0001771515-24-000075.txt : 20240319 0001771515-24-000075.hdr.sgml : 20240319 20240319170706 ACCESSION NUMBER: 0001771515-24-000075 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240315 FILED AS OF DATE: 20240319 DATE AS OF CHANGE: 20240319 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: 24764832 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_1710882411.xml FORM 4 X0508 4 2024-03-15 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 2024-03-15 4 G 0 8721 0 D 35065 D Common Stock 2024-03-15 4 G 0 8721 0 A 31167 I By Trust Common Stock 2024-03-18 4 S 0 8300 26.61 D 26765 D 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 2024-03-19