0001209191-19-017451.txt : 20190306
0001209191-19-017451.hdr.sgml : 20190306
20190306172459
ACCESSION NUMBER: 0001209191-19-017451
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190304
FILED AS OF DATE: 20190306
DATE AS OF CHANGE: 20190306
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Siegel Walter
CENTRAL INDEX KEY: 0001342060
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-27078
FILM NUMBER: 19663512
MAIL ADDRESS:
STREET 1: C/O STANDARD MICROSYSTEMS CORPORATION
STREET 2: 80 ARKAY DRIVE
CITY: HAUPPAUGE
STATE: NY
ZIP: 11788
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-03-04
0
0001000228
HENRY SCHEIN INC
HSIC
0001342060
Siegel Walter
C/O HENRY SCHEIN, INC.
135 DURYEA ROAD
MELVILLE
NY
11747
0
1
0
0
Senior VP & General Counsel
Common Stock, par value $0.01 per share
2019-03-04
4
D
0
2404
0.00
D
41606
D
Common Stock, par value $0.01 per share
2019-03-04
4
F
0
843
59.76
D
40763
D
Common Stock, par value $0.01 per share
2019-03-05
4
A
0
12008
0.00
A
52771
D
Represents the surrender of shares to the issuer to satisfy the reporting person's tax withholding obligation upon the vesting of the reporting person's March 4, 2016 grant of performance-based restricted stock/units.
Grant of restricted stock units (RSU) 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 performance goal and (y) reporting person's continued perf. of services for the Issuer. 35% will vest subject to (x) passage of a specified period of time and (y) reporting person's continued perf. of services for the Issuer. With respect to the performance-based RSU, if the continued service requirement is satisfied and achievement of the performance 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 performance 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 performance goal achieved that is below 100% of target (shortfall).
/s/ Jennifer Ferrero (as Attorney-in-Fact for Walter Siegel)
2019-03-06