0001209191-23-059459.txt : 20231221 0001209191-23-059459.hdr.sgml : 20231221 20231221170748 ACCESSION NUMBER: 0001209191-23-059459 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231220 FILED AS OF DATE: 20231221 DATE AS OF CHANGE: 20231221 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MLOTEK MARK E CENTRAL INDEX KEY: 0001194352 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27078 FILM NUMBER: 231506104 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] ORGANIZATION NAME: 07 Trade & Services 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 2023-12-20 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 0 Common Stock, par value $0.01 per share 2023-12-20 4 G 0 743 0.00 D 67895 D Common Stock, par value $0.01 per share 2100 I As Trustee of trusts for the benefit of family members. Common Stock, par value $0.01 per share 4088 I By 401(k) plan Gift, not applicable. Includes shares of Issuer's common stock held in joint tenancy with reporting person's spouse (the "Joint Account") and reflects the transfer on December 21, 2023 of 500 shares from the Joint Account to the trusts for the benefit of family members where Mr. Mlotek is a trustee (the "Trusts"). The amount in Column 5 reflects the transfer of 500 shares from the Joint Account to the Trusts on December 21, 2023. 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 December 19, 2023. /s/ Jennifer Ferrero (as Attorney-in-Fact for Mark E. Mlotek) 2023-12-21