0001209191-23-050368.txt : 20230922 0001209191-23-050368.hdr.sgml : 20230922 20230922160944 ACCESSION NUMBER: 0001209191-23-050368 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230920 FILED AS OF DATE: 20230922 DATE AS OF CHANGE: 20230922 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: 231271811 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: 1230 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 X0508 4 2023-09-20 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 0 Common Stock, par value $0.01 per share 2023-09-20 4 G 0 150 0.00 D 210270 D Common Stock, par value $0.01 per share 498184 I By Spouse Common Stock, par value $0.01 per share 9554 I by 401(k) plan Gift, not applicable. Represents (i) 144,736 shares held by the Bergman Family 2010 Trust #2, of which Mrs. Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary; (ii) 180 shares held by Mrs. Bergman; (iii) 329,410 shares held by the Bergman Family 2010 Trust #2, LLC, of which Mrs. Bergman is a manager; and (iv) 23,858 shares held by the SBMB GST Trusts Partners LLC, of which Mrs. Bergman 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 September 20, 2023. /s/ Jennifer Ferrero (as Attorney-in-Fact for Stanley M. Bergman) 2023-09-22