0001209191-19-007730.txt : 20190206 0001209191-19-007730.hdr.sgml : 20190206 20190206162302 ACCESSION NUMBER: 0001209191-19-007730 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181229 FILED AS OF DATE: 20190206 DATE AS OF CHANGE: 20190206 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MLOTEK MARK E CENTRAL INDEX KEY: 0001194352 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27078 FILM NUMBER: 19571854 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: 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 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2018-12-29 0 0 0 0001000228 HENRY SCHEIN INC HSIC 0001194352 MLOTEK MARK E C/O HENRY SCHEIN, INC. 135 DURYEA ROAD MELVILLE NY 11747 1 1 0 0 EVP, Chief Strategic Officer Common Stock, par value $0.01 per share 2018-12-05 5 G 0 1325 0.00 D 78181 D Common Stock, par value $0.01 per share 4093 I by 401(k) plan Gift, not applicable. /s/ Jennifer Ferrero (as Attorney-in-Fact for Mark E. Mlotek) 2019-02-06