0001209191-15-084803.txt : 20151211 0001209191-15-084803.hdr.sgml : 20151211 20151211181215 ACCESSION NUMBER: 0001209191-15-084803 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151209 FILED AS OF DATE: 20151211 DATE AS OF CHANGE: 20151211 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: 1229 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BERGMAN STANLEY M CENTRAL INDEX KEY: 0001008413 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27078 FILM NUMBER: 151284230 MAIL ADDRESS: STREET 1: C/O HENRY SCHEIN INC STREET 2: 135 DURYEA ROAD CITY: MELVILLE STATE: NY ZIP: 11747 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2015-12-09 0 0001000228 HENRY SCHEIN INC HSIC 0001008413 BERGMAN STANLEY M C/O HENRY SCHEIN, INC. 135 DURYEA ROAD MELVILLE NY 11747 1 1 0 0 Chairman, CEO Common Stock, par value $0.01 per share 2015-12-09 4 S 0 6589 154.77 D 553482 I By Spouse Common Stock, par value $0.01 per share 2015-12-09 4 S 0 4510 155.11 D 548972 I By Spouse Common Stock, par value $0.01 per share 2015-12-09 4 S 0 6301 157.44 D 542671 I By Spouse Common Stock, par value $0.01 per share 2015-12-09 4 S 0 8179 154.81 D 57829 I By Limited Liability Company Common Stock, par value $0.01 per share 2015-12-09 4 S 0 3485 155.11 D 54344 I By Limited Liability Company Common Stock, par value $0.01 per share 2015-12-09 4 S 0 6736 157.44 D 47608 I By Limited Liability Company Common Stock, par value $0.01 per share 2015-12-10 4 S 0 11000 154.84 D 531671 I By Spouse Common Stock, par value $0.01 per share 2015-12-10 4 S 0 2000 155.49 D 529671 I By Spouse Common Stock, par value $0.01 per share 2015-12-10 4 S 0 11050 154.83 D 36558 I By Limited Liability Company Common Stock, par value $0.01 per share 2015-12-10 4 S 0 1950 155.52 D 34608 I By Limited Liability Company Common Stock, par value $0.01 per share 2015-03-12 5 G 0 E 6034 0.00 D 161156 D Common Stock, par value $0.01 per share 2015-03-19 5 G 0 E 1438 0.00 D 159718 D Common Stock, par value $0.01 per share 2015-03-20 5 G 0 E 252 0.00 D 159466 D Common Stock, par value $0.01 per share 2015-04-06 5 G 0 E 363 0.00 D 159103 D Common Stock, par value $0.01 per share 2015-04-15 5 G 0 E 182 0.00 D 158921 D Common Stock, par value $0.01 per share 2015-05-13 5 G 0 E 178 0.00 D 158743 D Common Stock, par value $0.01 per share 2015-06-02 5 G 0 E 175 0.00 D 158568 D Common Stock, par value $0.01 per share 2015-06-08 5 G 0 E 844 0.00 D 157724 D Common Stock, par value $0.01 per share 2015-08-03 5 G 0 E 2160 0.00 D 155564 D Common Stock, par value $0.01 per share 2015-08-03 5 G 0 E 9255 0.00 D 520416 I By Spouse Common Stock, par value $0.01 per share 2015-08-04 5 G 0 E 1038 0.00 D 154526 D Common Stock, par value $0.01 per share 2015-08-11 5 G 0 E 360 0.00 D 154166 D Common Stock, par value $0.01 per share 2015-09-18 5 G 0 E 195 0.00 D 153971 D Common Stock, par value $0.01 per share 2015-10-13 5 G 0 E 386 0.00 D 153585 D Common Stock, par value $0.01 per share 2015-11-17 5 G 0 E 659 0.00 D 152926 D Common Stock, par value $0.01 per share 4391 I by 401(k) plan The price reflects a weighted average of sales made at prices ranging from $154.50 to $155.04 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. Represents (i) 553,350 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 132 shares held by Mrs. Bergman. The price reflects a weighted average of sales made at prices ranging from $155.05 to $155.35 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. Represents (i) 548,840 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 132 shares held by Mrs. Bergman. The price reflects a weighted average of sales made at prices ranging from $157.00 to $157.91 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. Represents (i) 542,539 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 132 shares held by Mrs. Bergman. Represents shares held by a limited liability company. Stanley M. Bergman and Marion Bergman, Mr. Bergman's wife, each have voting and dispositive power with respect to the shares held by the limited liability company. Mr. and Mrs. Bergman disclaim beneficial ownership of the shares held by the limited liability company. The price reflects a weighted average of sales made at prices ranging from $155.05 to $155.38 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 $154.35 to $155.30 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. Represents (i) 531,539 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 132 shares held by Mrs. Bergman. The price reflects a weighted average of sales made at prices ranging from $155.31 to $155.83 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. Represents (i) 529,539 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 132 shares held by Mrs. Bergman. The price reflects a weighted average of sales made at prices ranging from $154.36 to $155.30 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 $155.34 to $155.65 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. Gift, not applicable. Represents (i) 520,284 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 132 shares held by Mrs. Bergman. On August 3, 2015, the Bergman Family Trust 2 transferred 9,255 shares to Mrs. Bergman which is reflected in the number in Column 5 of this line item. /s/ Jennifer Ferrero (as Attorney-in-Fact for Stanley M. Bergman) 2015-12-11