0000899243-20-013356.txt : 20200515
0000899243-20-013356.hdr.sgml : 20200515
20200515214259
ACCESSION NUMBER: 0000899243-20-013356
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: Bortner Andrea Renee
CENTRAL INDEX KEY: 0001808260
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38950
FILM NUMBER: 20887601
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
2020-05-13
0
0001771515
Grocery Outlet Holding Corp.
GO
0001808260
Bortner Andrea Renee
C/O GROCERY OUTLET HOLDING CORP.
5650 HOLLIS STREET
EMERYVILLE
CA
94608
0
1
0
0
Chief Human Resources Officer
Common Stock
2020-05-13
4
A
0
14100
0.00
A
14100
D
Represents 14,100 restricted stock units ("RSUs") granted to the reporting person, of which 2,892 RSUs are scheduled to vest on March 1, 2021, 2,892 RSUs are scheduled to vest on March 1, 2022, 2,893 RSUs are scheduled to vest on March 1, 2023 and 5,423 RSUs are scheduled to vest on June 19, 2023, in each case, subject to the continued service of the reporting person through such vesting dates. Does not include up to an additional 13,016 unvested performance stock units at target achievement (or up to an additional 26,032 unvested performance stock units at maximum achievement) which are eligible to vest upon the achievement of certain performance-based vesting conditions.
/s/ Pamela B. Burke, Pamela B. Burke, as Attorney-In-Fact
2020-05-15