0001719844-21-000008.txt : 20211122 0001719844-21-000008.hdr.sgml : 20211122 20211122164217 ACCESSION NUMBER: 0001719844-21-000008 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211118 FILED AS OF DATE: 20211122 DATE AS OF CHANGE: 20211122 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: 211433152 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: 0101 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_163761731789601.xml FORM 4 X0306 4 2021-11-18 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 Common Stock 2021-11-18 4 M 0 5488 0 A 11237 D Common Stock 2021-11-18 4 F 0 2476 D 8761 D Restricted Stock Units 2021-11-18 4 M 0 5488 0 D Common Stock 5488.0 14109 D Each restricted stock unit represents a contingent right to receive one share of NVHI common stock. On November 18, 2021, 5,488 restricted stock units vested and 2,476 shares of the Company's common stock were withheld to satisfy tax withholding obligations. The closing price on November 18, 2021 of the Company's common stock on NASDAQ was $48.330 per share. On November 18, 2019, the reporting person was granted 5,488 restricted stock units, which will vest in three installments, with 5,488 shares vesting on the second anniversary of the grant date, 2,744 sharesvesting 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 2021-11-22