0001209191-12-015734.txt : 20120305 0001209191-12-015734.hdr.sgml : 20120305 20120305171808 ACCESSION NUMBER: 0001209191-12-015734 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120301 FILED AS OF DATE: 20120305 DATE AS OF CHANGE: 20120305 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ZACK MICHAEL CENTRAL INDEX KEY: 0001194355 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27078 FILM NUMBER: 12667561 MAIL ADDRESS: STREET 1: C/O HENRY SCHEIN INC STREET 2: 135 DURYEA RD CITY: MELVILLE STATE: NY ZIP: 11747 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HENRY SCHEIN INC CENTRAL INDEX KEY: 0001000228 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047] IRS NUMBER: 113136595 STATE OF INCORPORATION: DE FISCAL YEAR END: 1226 BUSINESS ADDRESS: STREET 1: 135 DURYEA RD CITY: MELVILLE STATE: NY ZIP: 11747 BUSINESS PHONE: 6318435500 MAIL ADDRESS: STREET 1: 135 DURYEA RD CITY: MELVILLE STATE: NY ZIP: 11747 FORMER COMPANY: FORMER CONFORMED NAME: SCHEIN HENRY INC DATE OF NAME CHANGE: 19950907 4 1 doc4.xml FORM 4 SUBMISSION X0304 4 2012-03-01 0 0001000228 HENRY SCHEIN INC HSIC 0001194355 ZACK MICHAEL C/O HENRY SCHEIN, INC. 135 DURYEA ROAD MELVILLE NY 11747 0 1 0 0 President of Int'l Group Common Stock, par value $0.01 per share 2012-03-01 4 M 0 7000 35.49 A 54399 D Common Stock, par value $0.01 per share 2012-03-01 4 S 0 7000 73.86 D 47399 D Common Stock, par value $0.01 per share 2012-03-01 4 M 0 24000 39.43 A 71399 D Common Stock, par value $0.01 per share 2012-03-01 4 S 0 24000 73.55 D 47399 D Common Stock, par value $0.01 per share 2012-03-02 4 A 0 10257 73.12 A 57656 D Common Stock, par value $0.01 per share 400 I By Son Common Stock, par value $0.01 per share 3553 I By 401(k) plan Stock Option (Right to Buy) 35.49 2012-03-01 4 M 0 7000 0.00 D 2014-02-18 Common Stock, par value $0.01 per share 7000 0 D Stock Option (Right to Buy) 39.43 2012-03-01 4 M 0 24000 0.00 D 2015-03-09 Common Stock, par value $0.01 per share 24000 0 D The price reflects a weighted average of sales made at prices ranging from $73.71 to $73.99 per share. The Reporting Person, upon request by the Securities and Exchange Commission staff, the issuer, or a security holder of the issuer, will provide full information regarding the number of shares sold at each separate price for this transaction. The price reflects a weighted average of sales made at prices ranging from $73.06 to $74.04 per share. The Reporting Person, upon request by the Securities and Exchange Commission staff, the issuer, or a security holder of the issuer, will provide full information regarding the number of shares sold at each separate price for this transaction. Grant of restricted stock units (RSUs) pursuant to the Issuer's 1994 Stock Incentive Plan, as amended. 65% will vest subject to (x) Issuer's achievement of a specified performance goal and (y) reporting person's continued performance of services for the Issuer. 35% will vest subject to (x) passage of a specified period of time and (y) reporting person's continued performance of services for the Issuer. With respect to the performance-based RSUs, if the continued service requirement is satisfied and achievement of the performance goal (x) exceeds 100% of target, the Issuer may issue additional vested shares of common stock in an amount that corresponds to the incremental percentage of the performance goal achieved in excess of 100% of target or (y) is less than 100% of target, the reporting person will surrender to the Issuer shares of common stock in an amount that corresponds to the incremental percentage of the performance goal achieved that is below 100% of target (i.e., shortfall). Acquired pursuant to the Issuer's 1994 Stock Incentive Plan, as amended. The option vests in four equal installments on each of February 18, 2005, February 18, 2006, February 18, 2007 and February 18, 2008. The option vests in four equal installments on each of March 9, 2006, March 9, 2007, March 9, 2008 and March 9, 2009. /s/ Michael Zack 2012-03-05