0001127602-22-019740.txt : 20220725 0001127602-22-019740.hdr.sgml : 20220725 20220725165027 ACCESSION NUMBER: 0001127602-22-019740 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220721 FILED AS OF DATE: 20220725 DATE AS OF CHANGE: 20220725 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: STAR JAMES A CENTRAL INDEX KEY: 0001260705 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38936 FILM NUMBER: 221104051 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Chewy, Inc. CENTRAL INDEX KEY: 0001766502 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-CATALOG & MAIL-ORDER HOUSES [5961] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 0202 BUSINESS ADDRESS: STREET 1: 1855 GRIFFIN ROAD, SUITE B-42 CITY: DANIA BEACH STATE: FL ZIP: 33004 BUSINESS PHONE: 786-320-7111 MAIL ADDRESS: STREET 1: 1855 GRIFFIN ROAD, SUITE B-42 CITY: DANIA BEACH STATE: FL ZIP: 33004 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2022-07-21 0001766502 Chewy, Inc. CHWY 0001260705 STAR JAMES A 1855 GRIFFIN ROAD, SUITE B-428 DANIA BEACH FL 33004 1 Class A Common Stock 2022-07-21 4 A 0 5145 0 A 5145 D Class A Common Stock 3523 D Class A Common Stock 325987 I See footnote Class A Common Stock 109050 D Represents restricted stock units granted to the reporting person on July 21, 2022 as compensation for service as a director. The restricted stock units will vest on the earlier of (1) the date of Chewy, Inc.'s annual meeting of stockholders in 2023, (2) one year from the date of grant, or (3) a change of control, each subject to the reporting person's continued service as a director on the Board of Directors of Chewy, Inc. through the vesting date. Each restricted stock unit represents a contingent right to receive one share of Class A common stock of Chewy, Inc. Represents vested restricted stock units that remain unsettled and will settle on the earliest of the date of the reporting person leaving the Board of Directors and a change in control of Chewy, Inc. Represents shares of Class A Common Stock owned by Downstream Partners, LP, in which the reporting person and his spouse have an indirect interest through a family trust. The reporting person disclaims beneficial ownership of the shares except to the extent of his pecuniary interest therein. /s/ Susan Helfrick, as Attorney-in-Fact for James A. Star 2022-07-25