0001710155-21-000041.txt : 20210611
0001710155-21-000041.hdr.sgml : 20210611
20210611164609
ACCESSION NUMBER: 0001710155-21-000041
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210609
FILED AS OF DATE: 20210611
DATE AS OF CHANGE: 20210611
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Johnson Susan S
CENTRAL INDEX KEY: 0001616181
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38257
FILM NUMBER: 211011916
MAIL ADDRESS:
STREET 1: 303 PEACHTREE STREET, NE
CITY: ATLANTA
STATE: GA
ZIP: 30308
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: National Vision Holdings, Inc.
CENTRAL INDEX KEY: 0001710155
STANDARD INDUSTRIAL CLASSIFICATION: OPHTHALMIC GOODS [3851]
IRS NUMBER: 464841717
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0101
BUSINESS ADDRESS:
STREET 1: 2435 COMMERCE AVENUE
STREET 2: BLDG. 2200
CITY: DULUTH
STATE: GA
ZIP: 30096-4980
BUSINESS PHONE: (770) 822-3600
MAIL ADDRESS:
STREET 1: 2435 COMMERCE AVENUE
STREET 2: BLDG. 2200
CITY: DULUTH
STATE: GA
ZIP: 30096-4980
4
1
wf-form4_162344435288258.xml
FORM 4
X0306
4
2021-06-09
0
0001710155
National Vision Holdings, Inc.
EYE
0001616181
Johnson Susan S
C/O NATIONAL VISION HOLDINGS, INC.
2435 COMMERCE AVENUE, BLDG 2200
DULUTH
GA
30096
1
0
0
0
Common Stock
2021-06-09
4
A
0
2061
0
A
4429
D
Restricted stock award granted as director compensation, which will vest on the first anniversary of the grant date, subject to continued service through the applicable vesting date.
/s/ Jared Brandman, as Attorney-in-Fact
2021-06-11