0001771515-23-000063.txt : 20230621 0001771515-23-000063.hdr.sgml : 20230621 20230621195849 ACCESSION NUMBER: 0001771515-23-000063 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230620 FILED AS OF DATE: 20230621 DATE AS OF CHANGE: 20230621 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: 231031251 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: 1230 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 wk-form4_1687391917.xml FORM 4 X0407 4 2023-06-20 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 0 Common Stock 2023-06-20 4 F 0 2689 28.72 D 46286 D These shares were withheld by the Issuer to satisfy the reporting person's tax withholding obligation upon vesting of RSUs previously granted. /s/ Lauri Fischer, Lauri Fischer, attorney-in-fact 2023-06-21