SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
West Roderick J

(Last) (First) (Middle)
100 MISSION RIDGE

(Street)
GOODLETTSVILLE TN 37072

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/01/2023
3. Issuer Name and Ticker or Trading Symbol
DOLLAR GENERAL CORP [ DG ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP, Global Supply Chain
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 8,334(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (Right to Buy) (2) 03/18/2024 Common Stock 1,516 $57.91 D
Employee Stock Option (Right to Buy) (3) 03/17/2025 Common Stock 1,790 $74.72 D
Employee Stock Option (Right to Buy) (4) 03/16/2026 Common Stock 2,691 $84.67 D
Employee Stock Option (Right to Buy) (5) 03/22/2027 Common Stock 3,230 $70.68 D
Employee Stock Option (Right to Buy) (6) 03/21/2028 Common Stock 1,768 $92.98 D
Employee Stock Option (Right to Buy) (7) 03/20/2029 Common Stock 1,443 $117.13 D
Employee Stock Option (Right to Buy) (8) 03/17/2030 Common Stock 2,006 $154.53 D
Employee Stock Option (Right to Buy) (9) 03/16/2031 Common Stock 3,877 $193.55 D
Employee Stock Option (Right to Buy) (10) 03/15/2032 Common Stock 7,037 $214.25 D
Employee Stock Option (Right to Buy) (11) 03/28/2033 Common Stock 4,007 $208.13 D
Explanation of Responses:
1. Includes 140 restricted stock units representing the right to receive shares of common stock upon vesting ("RSUs") that are scheduled to vest on April 1, 2024, subject to certain forfeiture and accelerated vesting provisions; 490 RSUs that are scheduled to vest evenly on April 1, 2024 and April 1, 2025, subject to certain forfeiture and accelerated vesting provisions; 552 RSUs that are scheduled to vest evenly on April 1, 2024, April 1, 2025 and April 1, 2026, subject to certain forfeiture and accelerated vesting provisions; 138 earned but unvested performance share units representing the right to receive shares of common stock upon vesting ("PSUs") that are scheduled to vest on April 1, 2024, subject to certain forfeiture and accelerated vesting provisions; and 378 earned but unvested PSUs that are scheduled to vest evenly on April 1, 2024 and April 1, 2025, subject to certain forfeiture and accelerated vesting provisions.
2. Vested as to 758 shares on each of March 18, 2017 and March 18, 2018.
3. Vested as to 895 shares on each of April 1, 2018 and April 1, 2019.
4. Vested as to 897 shares on each of April 1, 2018, April 1, 2019 and April 1, 2020.
5. Vested as to 809 shares on April 1, 2018 and as to 807 shares on each of April 1, 2019, April 1, 2020 and April 1, 2021.
6. Vested as to 1 share on April 1, 2019 and as to 589 shares on each of April 1, 2020, April 1, 2021 and April 1, 2022.
7. Vested as to 481 shares on each of April 1, 2021, April 1, 2022 and April 1, 2023.
8. Vested as to 503 shares on April 1, 2021 and as to 501 shares on each of April 1, 2022 and April 1, 2023. The remaining portion of the option is scheduled to vest as to 501 shares on April 1, 2024, subject to certain forfeiture and accelerated vesting provisions.
9. Vested as to 970 shares on April 1, 2022 and as to 969 shares on April 1, 2023. The remaining portion of the option is scheduled to vest as to 969 shares on each of April 1, 2024 and April 1, 2025, subject to certain forfeiture and accelerated vesting provisions.
10. Vested as to 1,760 shares on April 1, 2023. The remaining portion of the option is scheduled to vest as to 1,759 shares on each of April 1, 2024, April 1, 2025 and April 1, 2026, subject to certain forfeiture and accelerated vesting provisions.
11. Vests in four annual installments of 25% beginning April 1, 2024, subject to certain forfeiture and accelerated vesting provisions.
Remarks:
Exhibit List: Exhibit 24--Power of Attorney
/s/ Roderick J. West 09/05/2023
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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