0001771515-22-000075.txt : 20220526
0001771515-22-000075.hdr.sgml : 20220526
20220526192816
ACCESSION NUMBER: 0001771515-22-000075
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220525
FILED AS OF DATE: 20220526
DATE AS OF CHANGE: 20220526
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Burke Pamela B.
CENTRAL INDEX KEY: 0001779772
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38950
FILM NUMBER: 22972179
MAIL ADDRESS:
STREET 1: 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: 1231
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
wf-form4_165360766961023.xml
FORM 4
X0306
4
2022-05-25
0
0001771515
Grocery Outlet Holding Corp.
GO
0001779772
Burke Pamela B.
C/O GROCERY OUTLET HOLDING CORP.,
5650 HOLLIS STREET
EMERYVILLE
CA
94608
0
1
0
0
See Remarks
Common Stock
2022-05-25
4
M
0
15000
11.64
A
43108
D
Common Stock
2022-05-25
4
S
0
15000
38.79
D
28108
D
Stock Options (Right to Buy)
11.64
2022-05-25
4
M
0
15000
0
D
2028-12-26
Common Stock
15000.0
34105
D
These stock options are vested and exercisable.
Chief Stores Officer, Interim General Counsel and Secretary
/s/ Lauri Fischer, Lauri Fischer Attorney-in-Fact
2022-05-26