0001209191-23-054689.txt : 20231108 0001209191-23-054689.hdr.sgml : 20231108 20231108160929 ACCESSION NUMBER: 0001209191-23-054689 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20231106 FILED AS OF DATE: 20231108 DATE AS OF CHANGE: 20231108 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JACKSON SAM CENTRAL INDEX KEY: 0001998218 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32242 FILM NUMBER: 231387900 MAIL ADDRESS: STREET 1: 30 FRANK LLOYD WRIGHT DRIVE CITY: ANN ARBOR STATE: MI ZIP: 48105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DOMINOS PIZZA INC CENTRAL INDEX KEY: 0001286681 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-GROCERIES & RELATED PRODUCTS [5140] IRS NUMBER: 382511577 STATE OF INCORPORATION: DE FISCAL YEAR END: 0102 BUSINESS ADDRESS: STREET 1: 30 FRANK LLOYD WRIGHT DRIVE CITY: ANN ARBOR STATE: MI ZIP: 48105 BUSINESS PHONE: (734) 930-3030 MAIL ADDRESS: STREET 1: 30 FRANK LLOYD WRIGHT DRIVE CITY: ANN ARBOR STATE: MI ZIP: 48105 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2023-11-06 0 0001286681 DOMINOS PIZZA INC DPZ 0001998218 JACKSON SAM 30 FRANK LLOYD WRIGHT DR ANN ARBOR MI 48105 0 1 0 0 EVP, Human Resources Common Stock, $0.01 par value 2500 D Option to Purchase Common Stock 283.68 2022-07-18 2028-07-18 Common Stock, $0.01 par value 520 D Option to Purchase Common Stock 275.35 2023-07-10 2029-07-10 Common Stock, $0.01 par value 590 D Option to Purchase Common Stock 413.68 2024-07-15 2030-07-15 Common Stock, $0.01 par value 380 D Option to Purchase Common Stock 413.68 2024-07-15 2030-07-15 Common Stock, $0.01 par value 120 D Option to Purchase Common Stock 367.79 2024-03-31 2031-03-31 Common Stock, $0.01 par value 450 D Option to Purchase Common Stock 393.14 2025-03-10 2032-03-10 Common Stock, $0.01 par value 429 D Option to Purchase Common Stock 300.16 2026-03-10 2033-03-10 Common Stock, $0.01 par value 530 D Includes 75 shares of common stock representing the final tranche of an original grant of performance-based restricted stock that shall vest on July 15, 2024 if applicable performance conditions are achieved. Includes 25 shares of common stock representing the final tranche of an original grant of performance-based restricted stock that shall vest on July 15, 2024 if applicable performance conditions are achieved. Includes 115 shares of common stock representing the final tranche of an original restricted stock unit award with service-based vesting criteria that shall vest on March 31, 2024. Shares are issued and delivered following each vesting tranche of the award. Includes 147 shares of common stock representing the final tranche of an original restricted stock unit award with service-based vesting criteria that shall vest on July 19, 2024. Shares are issued and delivered following each vesting tranche of the award. Includes 1,578 shares of common stock representing an original restricted stock unit award with service-based vesting criteria that shall vest one-fourth on March 10, 2024, one-fourth on March 10, 2025 and one-half on March 10, 2026. Shares are issued and delivered following each vesting tranche of the award. Includes 237 shares of common stock representing the final two tranches of an original restricted stock unit award with service-based vesting criteria that shall vest one-half on each of March 10, 2024 and March 10, 2025. Shares are issued and delivered following each vesting tranche of the award. Includes 323 shares of common stock representing an original restricted stock unit award with service-based vesting criteria that shall vest one-third on each of March 10, 2024, March 10, 2025 and March 10, 2026. Shares are issued and delivered following each vesting tranche of the award. The options to purchase common stock vest one-fourth each year on the anniversary date of the grant date. Thus, one-fourth vested on each of July 15, 2021, July 15, 2022 and July 15, 2023 and one-fourth shall vest on July 15, 2024. The options to purchase common stock vest one-third each year on the anniversary date of the grant date. Thus, one-third vested on each of March 31, 2022 and March 31, 2023 and one-third shall vest on March 31, 2024. The options to purchase common stock vest one-third each year on the anniversary date of the grant date. Thus, one-third vested on March 10, 2023 and one-third shall vest on each of March 10, 2024 and March 10, 2025. The options to purchase common stock vest one-third each year on the anniversary date of the grant date. Thus, one-third shall vest on each of March 10, 2024, March 10, 2025 and March 10, 2026. /s/ Kevin S. Morris, attorney-in-fact 2023-11-08 EX-24 2 poa.txt POA DOCUMENT POWER OF ATTORNEY Know all by these present, that the undersigned hereby constitutes and appoints Kevin S. Morris, Joseph W. Clementz and Stacey M. Rodriguez, signing singly, the undersigned's true and lawful attorney-in-fact to: (1) execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director of Domino's Pizza, Inc. (the "Company"), Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder; (2) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the United States Securities and Exchange Commission and any stock exchange or similar authority; and (3) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934. This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 18th of October, 2023. /s/ Sam Jackson Print: Sam Jackson WITNESS: /s/ Mary Allen Print: Mary Allen