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