0001771515-24-000112.txt : 20240605 0001771515-24-000112.hdr.sgml : 20240605 20240605171445 ACCESSION NUMBER: 0001771515-24-000112 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240603 FILED AS OF DATE: 20240605 DATE AS OF CHANGE: 20240605 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jaros Carey F. CENTRAL INDEX KEY: 0001823561 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38950 FILM NUMBER: 241022979 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_1717622077.xml FORM 4 X0508 4 2024-06-03 0 0001771515 Grocery Outlet Holding Corp. GO 0001823561 Jaros Carey F. C/O GROCERY OUTLET HOLDING CORP. 5650 HOLLIS STREET EMERYVILLE CA 94608 1 0 0 0 0 Common Stock 2024-06-03 4 A 0 6803 0 A 20374 D Represents 6,803 restricted stock units ("RSUs") granted to the reporting person which are scheduled to vest on the earlier of (i) the date of the next annual meeting of stockholders following the date of grant; or (ii) June 3, 2025, subject to the continued service of the reporting person through such vesting date. The RSUs represent the annual equity retainer under the Issuer's non-employee director compensation policy. /s/ Lauri Fischer, Lauri Fischer, attorney-in-fact 2024-06-05