0001209191-23-016750.txt : 20230307 0001209191-23-016750.hdr.sgml : 20230307 20230307162935 ACCESSION NUMBER: 0001209191-23-016750 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230303 FILED AS OF DATE: 20230307 DATE AS OF CHANGE: 20230307 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: 23712999 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: 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 2023-03-03 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 2023-03-03 4 A 0 7378 0.00 A 112609 D Common Stock, par value $0.01 per share 2023-03-03 4 F 0 10360 78.90 D 102249 D Common Stock, par value $0.01 per share 2023-03-03 4 F 0 2279 78.90 D 99970 D Common Stock, par value $0.01 per share 2023-03-03 4 F 0 5355 78.90 D 94615 D Common Stock, par value $0.01 per share 870 I As Trustee of trusts for the benefit of family members. Common Stock, par value $0.01 per share 4090 I By 401(k) plan Represents additional shares of the Issuer's common stock issued under the Henry Schein, Inc. 2013 Stock Incentive Plan, (now known as the Henry Schein, Inc. 2020 Stock Incentive Plan) that vested on March 3, 2023 in connection with exceeding the performance target with respect to the reporting person's March 3, 2020 grant of performance-based restricted stock units. Includes shares of Issuer's common stock held in joint tenancy with reporting person's spouse. 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 3, 2020 grant of performance-based restricted stock units. 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 3, 2021 grant of time-based restricted stock units. 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 5, 2019 grant of time-based restricted stock units. (Actual vesting date of March 5, 2023 was a non-business day so vesting occurred on the preceding business day.) 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 3, 2023. /s/ Jennifer Ferrero (as Attorney-in-Fact for Mark E. Mlotek) 2023-03-07