Statement of Changes in Beneficial Ownership (4)
April 13 2023 - 4:22PM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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VanDette Joseph |
2. Issuer Name and Ticker or Trading Symbol
National Vision Holdings, Inc.
[
EYE
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) SVP, Chief Marketing Officer |
(Last)
(First)
(Middle)
C/O NATIONAL VISION HOLDINGS, INC., 2435 COMMERCE AVENUE, BLDG 2200 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
4/11/2023 |
(Street)
DULUTH, GA 30096 |
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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(City)
(State)
(Zip)
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Rule 10b5-1(c) Transaction Indication
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Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to
satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 4/11/2023 | | M | | 1156 | A | $0 (1) | 1156 | D | |
Common Stock | 4/11/2023 | | F | | 410 | D | $0 (2) | 746 | D | |
Common Stock | 4/11/2023 | | M | | 1830 | A | $0 (1) | 2576 | D | |
Common Stock | 4/11/2023 | | F | | 648 | D | $0 (3) | 1928 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Restricted Stock Units | (1) | 4/11/2023 | | M | | | 1156 | (4) | (4) | Common Stock | 1156.0 | $0 | 25697 | D | |
Restricted Stock Units | (1) | 4/11/2023 | | M | | | 1830 | (5) | (5) | Common Stock | 1830.0 | $0 | 23867 | D | |
Explanation of Responses: |
(1) | Each restricted stock unit represents a contingent right to receive one share of NVHI common stock. |
(2) | On April 11, 2023, 1,156 restricted stock units vested and 410 shares of the Company's stock were withheld to satisfy tax withholding obligations. The closing price on April 11, 2023 of the Company's common stock on NASDAQ was $20.30 per share. |
(3) | On April 11, 2023, 1,830 restricted stock units vested and 648 shares of the Company's stock were withheld to satisfy tax withholding obligations. The closing price on April 11, 2023 of the Company's common stock on NASDAQ was $20.30 per share. |
(4) | On April 11, 2022, the reporting person was granted 2,312 restricted stock units, vesting in two equal installments beginning on the first anniversary of the grant date. |
(5) | On April 11, 2022, the reporting person was granted 5,491 restricted stock units, vesting in three equal installments beginning on the first anniversary of the grant date. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
VanDette Joseph C/O NATIONAL VISION HOLDINGS, INC. 2435 COMMERCE AVENUE, BLDG 2200 DULUTH, GA 30096 |
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| SVP, Chief Marketing Officer |
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Signatures
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/s/ Jared Brandman, Attorney-in-Fact | | 4/13/2023 |
**Signature of Reporting Person | Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
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