0000105418-22-000001.txt : 20220111 0000105418-22-000001.hdr.sgml : 20220111 20220111144639 ACCESSION NUMBER: 0000105418-22-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211029 FILED AS OF DATE: 20220111 DATE AS OF CHANGE: 20220111 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Weis Jennifer CENTRAL INDEX KEY: 0001660464 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-05039 FILM NUMBER: 22523646 MAIL ADDRESS: STREET 1: C/O WEIS MARKETS, INC. STREET 2: 1000 SOUTH SECOND STREET, PO BOX 471 CITY: SUNBURY STATE: PA ZIP: 17801 FORMER NAME: FORMER CONFORMED NAME: Monsky Jennifer Weis DATE OF NAME CHANGE: 20151209 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: WEIS MARKETS INC CENTRAL INDEX KEY: 0000105418 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-GROCERY STORES [5411] IRS NUMBER: 240755415 STATE OF INCORPORATION: PA FISCAL YEAR END: 1225 BUSINESS ADDRESS: STREET 1: 1000 S SECOND ST STREET 2: PO BOX 471 CITY: SUNBURY STATE: PA ZIP: 17801 BUSINESS PHONE: 570-286-4571 MAIL ADDRESS: STREET 1: 1000 S SECOND ST STREET 2: PO BOX 471 CITY: SUNBURY STATE: PA ZIP: 17801 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2021-10-29 0 0000105418 WEIS MARKETS INC WMK 0001660464 Weis Jennifer C/O WEIS MARKETS, INC. 1000 SOUTH SECOND STREET, PO BOX 471 SUNBURY PA 17801 0 0 0 1 Member of a 10% owner group Common Stock 2021-10-29 5 G 0 E 118683 D 1079275 D Common Stock 2021-10-29 5 G 0 E 118683 A 118683 I By Family Trust Common Stock 49360 I By 1976 JHW Trust Common Stock 23766 I By Trusts for the Benefit of Children Common Stock 7922 I Held by Child Common Stock 2005 I Held by Spouse Not applicable / no consideration. These shares are held in a trust for the benefit of the reporting person's children. The reporting person's spouse is a trustee of the trust. /s/ Jennifer Weis 2021-01-10