0000899243-20-011608.txt : 20200429 0000899243-20-011608.hdr.sgml : 20200429 20200429194959 ACCESSION NUMBER: 0000899243-20-011608 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200427 FILED AS OF DATE: 20200429 DATE AS OF CHANGE: 20200429 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McAndrews Brian CENTRAL INDEX KEY: 0001808258 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38950 FILM NUMBER: 20832575 MAIL ADDRESS: STREET 1: C/O GROCERY OUTLET HOLDING CORP. STREET 2: 5650 HOLLIS STREET CITY: EMERYVILLE STATE: CA ZIP: 94608 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Grocery Outlet Holding Corp. CENTRAL INDEX KEY: 0001771515 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-GROCERY STORES [5411] IRS NUMBER: 471874201 STATE OF INCORPORATION: DE FISCAL YEAR END: 1228 BUSINESS ADDRESS: STREET 1: 5650 HOLLIS STREET CITY: EMERYVILLE STATE: CA ZIP: 94608 BUSINESS PHONE: (510) 845-1999 MAIL ADDRESS: STREET 1: 5650 HOLLIS STREET CITY: EMERYVILLE STATE: CA ZIP: 94608 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-04-27 0 0001771515 Grocery Outlet Holding Corp. GO 0001808258 McAndrews Brian C/O GROCERY OUTLET HOLDING CORP. 5650 HOLLIS STREET EMERYVILLE CA 94608 0 1 0 0 SVP, Store Development Stock Options (Right to Buy) 10.30 2020-04-27 4 A 0 22587 0.00 A 2028-06-25 Common Stock 22587 77165 D Represents stock options which were deemed earned and acquired upon the satisfaction of certain performance vesting criteria in connection with the secondary public offering. These stock options are vested and exercisable. /s/ Pamela B. Burke, Pamela B. Burke, as Attorney-in-Fact 2020-04-29