0001209191-21-057780.txt : 20210927
0001209191-21-057780.hdr.sgml : 20210927
20210927161937
ACCESSION NUMBER: 0001209191-21-057780
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210924
FILED AS OF DATE: 20210927
DATE AS OF CHANGE: 20210927
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ALI MOHAMAD
CENTRAL INDEX KEY: 0001580247
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-27078
FILM NUMBER: 211281949
MAIL ADDRESS:
STREET 1: 2 AVENUE DE LAFAYETTE
CITY: BOSTON
STATE: MA
ZIP: 02111
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: 1225
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
2021-09-24
0
0001000228
HENRY SCHEIN INC
HSIC
0001580247
ALI MOHAMAD
C/O HENRY SCHEIN, INC.
135 DURYEA ROAD
MELVILLE
NY
11747
1
0
0
0
Common Stock, par value $0.01 per share
3790
D
Deferred Compensation Plan Phantom Stock
2021-09-24
4
A
0
344
0.00
A
Common Stock, par value $0.01 per share
344
893
D
Each share of phantom stock is the economic equivalent of one share of the Issuer's common stock.
Represents the number of shares of phantom stock credited to the reporting person's phantom stock account pursuant to the Issuer's Non-Employee Director Deferred Compensation Plan (the "Plan"), representing an exempt transaction under the Plan. The number of shares of phantom stock credited to the reporting person's phantom stock account is determined by dividing the amount of deferred eligible director fees by the closing price of a share of Issuer common stock on the award date.
The balance in the reporting person's phantom share account is distributed to the reporting person in Issuer common stock following the termination of the reporting person's directorship, the reporting person's death or disability or a change of control of the Issuer.
Represents the aggregate number of shares of phantom stock allocated to the reporting person under the Plan as of the award date based on the closing price of a share of the Issuer's common stock on the award date.
/s/ Jennifer Ferrero (as Attorney-in-Fact for Mohamad Ali)
2021-09-27