0000899243-21-010519.txt : 20210308 0000899243-21-010519.hdr.sgml : 20210308 20210308210952 ACCESSION NUMBER: 0000899243-21-010519 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210304 FILED AS OF DATE: 20210308 DATE AS OF CHANGE: 20210308 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mayo Heather L. CENTRAL INDEX KEY: 0001808259 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38950 FILM NUMBER: 21723858 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] IRS NUMBER: 471874201 STATE OF INCORPORATION: DE FISCAL YEAR END: 0102 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 doc4.xml FORM 4 SUBMISSION X0306 4 2021-03-04 0 0001771515 Grocery Outlet Holding Corp. GO 0001808259 Mayo Heather L. C/O GROCERY OUTLET HOLDING CORP. 5650 HOLLIS STREET EMERYVILLE CA 94608 0 1 0 0 See Remarks Common Stock 2021-03-04 4 A 0 9298 0.00 A 23398 D Common Stock 2021-03-04 4 S 0 931 35.267 D 22467 D Represents 9,298 restricted stock units ("RSUs") granted to the reporting person that will entitle the reporting person to receive one share of the Issuer's Common Stock per RSU. The RSUs will vest, and the underlying shares will be concurrently issued in a series of three equal installments upon the reporting person's completion of each 12 month period of service over the period measured from March 1, 2021 to March 1, 2024, subject to the continued service of the reporting person through such vesting dates. Does not include up to an additional 13,947 unvested performance stock units at target achievement (or up to an additional 27,893 unvested performance stock units at maximum achievement) which are eligible to vest upon the achievement of certain performance-based vesting conditions. These shares were sold to satisfy the reporting person's tax withholding obligation upon vesting of RSUs previously granted. EVP, Chief Sales and Merchandising Officer, East /s/ Pamela B. Burke, Pamela B. Burke, as Attorney-In-Fact 2021-03-08