0001209191-21-017775.txt : 20210304
0001209191-21-017775.hdr.sgml : 20210304
20210304161008
ACCESSION NUMBER: 0001209191-21-017775
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210302
FILED AS OF DATE: 20210304
DATE AS OF CHANGE: 20210304
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BERGMAN STANLEY M
CENTRAL INDEX KEY: 0001008413
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-27078
FILM NUMBER: 21714242
MAIL ADDRESS:
STREET 1: C/O HENRY SCHEIN INC
STREET 2: 135 DURYEA ROAD
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: 1226
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
2021-03-02
0
0001000228
HENRY SCHEIN INC
HSIC
0001008413
BERGMAN STANLEY M
C/O HENRY SCHEIN, INC.
135 DURYEA ROAD
MELVILLE
NY
11747
1
1
0
0
Chairman, CEO
Common Stock, par value $0.01 per share
2021-03-02
4
D
0
46122
0.00
D
228144
D
Common Stock, par value $0.01 per share
624849
I
By Spouse
Common Stock, par value $0.01 per share
9323
I
by 401(k) plan
Represents (i) 283,895 shares held by the Bergman Family 2010 Trust #2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary; (ii) 1,068 shares held by Mrs. Bergman and (iii) 339,886 shares held by the Bergman Family 2010 Trust #2, LLC of which Marion Bergman, Stanley M. Bergman's wife, is a manager.
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 2, 2021.
/s/ Jennifer Ferrero (as Attorney-in-Fact for Stanley M. Bergman)
2021-03-04