0000899243-20-013344.txt : 20200515 0000899243-20-013344.hdr.sgml : 20200515 20200515213447 ACCESSION NUMBER: 0000899243-20-013344 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200513 FILED AS OF DATE: 20200515 DATE AS OF CHANGE: 20200515 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lindberg Eric J. Jr. CENTRAL INDEX KEY: 0001779740 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38950 FILM NUMBER: 20887581 MAIL ADDRESS: STREET 1: GROCERY OUTLET HOLDING CORP. STREET 2: 56560 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 2020-05-13 0 0001771515 Grocery Outlet Holding Corp. GO 0001779740 Lindberg Eric J. Jr. C/O GROCERY OUTLET HOLDING CORP. 5650 HOLLIS STREET EMERYVILLE CA 94608 1 1 0 0 Chief Executive Officer Common Stock 2020-05-13 4 A 0 25136 0.00 A 25136 D Common Stock 2126670 I By Lindberg Revocable Trust Common Stock 701500 I By Lindberg Irrevocable Trust Common Stock 460 I By child Common Stock 460 I By spouse Represents 25,136 restricted stock units ("RSUs") granted to the reporting person, of which 8,378 RSUs are scheduled to vest on March 1, 2021, 8,378 RSUs are scheduled to vest on March 1, 2022 and 8,380 RSUs are scheduled to vest on March 1, 2023, in each case, subject to the continued service of the reporting person through such vesting dates. Does not include up to an additional 58,650 unvested performance stock units at target achievement (or up to an additional 117,300 unvested performance stock units at maximum achievement) which are eligible to vest upon the achievement of certain performance-based vesting conditions. Reflects shares directly held by The Lindberg Family Revocable Trust u/a/d 2/14/2006 of which Mr. Lindberg is a Trustee Reflects shares directly held by The Lindberg Family Irrevocable Trust u/a/d 5/12/2017 of which Mr. Lindberg is a Trustee. /s/ Pamela B. Burke, Pamela B. Burke, as Attorney-In-Fact 2020-05-15