0001209191-22-020155.txt : 20220318 0001209191-22-020155.hdr.sgml : 20220318 20220318200512 ACCESSION NUMBER: 0001209191-22-020155 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220316 FILED AS OF DATE: 20220318 DATE AS OF CHANGE: 20220318 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Serota Scott Philip CENTRAL INDEX KEY: 0001898921 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27078 FILM NUMBER: 22753970 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: 1231 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 2022-03-16 0 0001000228 HENRY SCHEIN INC HSIC 0001898921 Serota Scott Philip C/O HENRY SCHEIN, INC. 135 DURYEA ROAD MELVILLE NY 11747 1 0 0 0 Common Stock, par value $0.01 per share 2022-03-16 4 A 0 2028 0.00 A 2028 D Common Stock, par value $0.01 per share 1000 I By trust Acquired pursuant to the Issuer's 2015 Non-Employee Director Stock Incentive Plan. Subject to certain exceptions, such restricted stock/units will vest subject to (i) the passage of a specified period of time and (ii) the reporting person's continued performance of services for the Issuer. Represents shares held by the Serota Family Trust, dated May 24, 2013 of which Mr. Serota and his wife are both the trustees and beneficiaries. /s/ Jennifer Ferrero (as Attorney-in-Fact for Scott P. Serota) 2022-03-18