0001209191-20-017670.txt : 20200310 0001209191-20-017670.hdr.sgml : 20200310 20200310162701 ACCESSION NUMBER: 0001209191-20-017670 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200306 FILED AS OF DATE: 20200310 DATE AS OF CHANGE: 20200310 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MLOTEK MARK E CENTRAL INDEX KEY: 0001194352 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27078 FILM NUMBER: 20701870 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: 1228 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 2020-03-06 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 2020-03-06 4 D 0 2166 0.00 D 124373 D Common Stock, par value $0.01 per share 2020-03-06 4 F 0 4604 57.69 D 119769 D Common Stock, par value $0.01 per share 4095 I by 401(k) plan 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 6, 2017 grant of performance-based restricted stock/units. Reflects the reporting person's interest in equivalent shares of Henry Schein common stock held by the unitized stock fund in the Henry Schein, Inc. 401(k) Savings Plan (the "Plan"). The unitized stock fund consists of Henry Schein common stock and cash or cash equivalents. The number of shares attributed to the reporting person as a participant in the Plan and expressed as equivalent shares has been calculated based on the closing price of Henry Schein common stock on March 6, 2020. /s/ Jennifer Ferrero (as Attorney-in-Fact for Mark E. Mlotek) 2020-03-10