SEC Form 4/A · accession 0001209191-16-092924
HENRY SCHEIN INC · HSIC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Louis W Sullivan
Director
Period of report
Jun 30, 2015
Accepted (ET)
Jan 21, 2016 · 5:19 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001000228
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Deferred Compensation Plan Phantom StockF2,F3,F5,F1,F4 | — | Jun 30, 2015 | A | 137 | A | — | — | Common Stock, par value $0.01 per share | 137 | 10,466 | D |
Explanation of responses
- F1Each share of phantom stock is the economic equivalent of one share of the Issuer's common stock.
- F2This amendment is being filed to correct the amount of phantom stock the reporting person received on June 30, 2015. The original filing underreported the amount of phantom stock due to an administrative error. Taking into account this correction, the amount of phantom stock the reporting person beneficially owned following the transactions reported in the Forms 4 filed on October 1, 2015 and January 4, 2016 should be 10,610 and 10,694, respectively.
- F3Represents the number of shares of phantom stock credited to the reporting person's phantom stock account pursuant to the Issuer's Non-Employee Director Deferred Compensation Plan (the "Plan"), representing an exempt transaction under the Plan. The number of shares of phantom stock credited to the reporting person's phantom stock account is determined by dividing the amount of deferred eligible director fees by the closing price of a share of the Issuer's common stock on the award date.
- F4The balance in the reporting person's phantom stock account is distributed to the reporting person in Issuer common stock following the termination of the reporting person's directorship, the reporting person's death or disability or a change of control of the Issuer.
- F5Represents the aggregate number of shares of phantom stock allocated to the reporting person under the Plan as of the award date based on the closing price of a share of the Issuer's common stock on the award date.