0001209191-17-019223.txt : 20170308 0001209191-17-019223.hdr.sgml : 20170308 20170308160633 ACCESSION NUMBER: 0001209191-17-019223 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170306 FILED AS OF DATE: 20170308 DATE AS OF CHANGE: 20170308 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: BRESLAWSKI JAMES P CENTRAL INDEX KEY: 0001194347 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27078 FILM NUMBER: 17675159 MAIL ADDRESS: STREET 1: C/O HENRY SCHEIN INC STREET 2: 135 DURYEA RD CITY: MELVILLE STATE: NY ZIP: 11747 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-03-06 0 0001000228 HENRY SCHEIN INC HSIC 0001194347 BRESLAWSKI JAMES P C/O HENRY SCHEIN, INC. 135 DURYEA ROAD MELVILLE NY 11747 1 1 0 0 Pres., HSI & CEO Global Dental Common Stock, par value $0.01 per share 2017-03-06 4 A 0 9362 0.00 A 113486 D Common Stock, par value $0.01 per share 2017-03-06 4 S 0 8486 170.35 D 105000 D Grant of restricted stock units (RSUs) pursuant to the Issuer's 2013 Stock Incentive Plan. Subject to certain exceptions, 65% will vest subject to (x) Issuer's achievement of a specified perf. 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 perf.-based RSUs, if the continued service requirement is satisfied and achievement of the perf. 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 perf. 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 perf. goal achieved that is below 100% of target (i.e., shortfall). The price reflects a weighted average of sales made at prices ranging from $170.02 to $170.70 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. /s/ Jennifer Ferrero (as Attorney-in-Fact for James P. Breslawski) 2017-03-08