0001771515-24-000059.txt : 20240306 0001771515-24-000059.hdr.sgml : 20240306 20240306171651 ACCESSION NUMBER: 0001771515-24-000059 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240304 FILED AS OF DATE: 20240306 DATE AS OF CHANGE: 20240306 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bortner Andrea Renee CENTRAL INDEX KEY: 0001808260 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38950 FILM NUMBER: 24727043 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] ORGANIZATION NAME: 07 Trade & Services 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 wk-form4_1709763398.xml FORM 4 X0508 4 2024-03-04 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 See Remarks 0 Common Stock 2024-03-04 4 S 0 4112 26.33 D 49308 D Common Stock 22446 I By Trust These shares were sold to satisfy the reporting person's tax withholding obligation upon vesting of RSUs previously granted. Reflects shares directly held by the Bortner Family Trust of which Ms. Bortner is a Trustee. EVP, Chief Human Resources Officer /s/ Lauri Fischer, Lauri Fischer, attorney-in-fact 2024-03-06