0001719844-19-000006.txt : 20191120 0001719844-19-000006.hdr.sgml : 20191120 20191120163623 ACCESSION NUMBER: 0001719844-19-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191118 FILED AS OF DATE: 20191120 DATE AS OF CHANGE: 20191120 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Moore Patrick R. CENTRAL INDEX KEY: 0001719844 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38257 FILM NUMBER: 191234637 MAIL ADDRESS: STREET 1: C/O NATIONAL VISION HOLDINGS, INC. STREET 2: 2435 COMMERCE AVENUE, BLDG. 2200 CITY: DULUTH STATE: GA ZIP: 30096 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: National Vision Holdings, Inc. CENTRAL INDEX KEY: 0001710155 STANDARD INDUSTRIAL CLASSIFICATION: OPHTHALMIC GOODS [3851] IRS NUMBER: 464841717 STATE OF INCORPORATION: DE FISCAL YEAR END: 1228 BUSINESS ADDRESS: STREET 1: 2435 COMMERCE AVENUE STREET 2: BLDG. 2200 CITY: DULUTH STATE: GA ZIP: 30096-4980 BUSINESS PHONE: (770) 822-3600 MAIL ADDRESS: STREET 1: 2435 COMMERCE AVENUE STREET 2: BLDG. 2200 CITY: DULUTH STATE: GA ZIP: 30096-4980 4 1 wf-form4_157428576699705.xml FORM 4 X0306 4 2019-11-18 0 0001710155 National Vision Holdings, Inc. EYE 0001719844 Moore Patrick R. C/O NATIONAL VISION HOLDINGS, INC., 2435 COMMERCE AVENUE, BLDG. 2200 DULUTH GA 30096-4980 0 1 0 0 SVP, Chief Financial Officer Restricted Stock Units 2019-11-18 4 A 0 10977 0 A Common Stock 10977.0 10977 D Each restricted stock unit represents a contingent right to receive one share of NVHI common stock. The restricted stock units will vest in three installments, with 5,488 shares vesting on the second anniversary of the grant date, 2,744 shares vesting on the third anniversary of the grant date and 2,745 shares vesting on the fourth anniversary of the grant date. /s/ Jared Brandman, as Attorney-in-Fact 2019-11-20