SEC Form 4 · accession 0001209191-16-149061
HENRY SCHEIN INC · HSIC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Stanley M Bergman
Officer — Chairman, CEO · Director
Period of report
Nov 7, 2016
Accepted (ET)
Nov 9, 2016 · 4:37 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001000228
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, par value $0.01 per shareF1 | Jul 13, 2016 | G | 150 | $0.00 | D | 174,248 | D | |
| Common Stock, par value $0.01 per shareF1 | Aug 12, 2016 | G | 320 | $0.00 | D | 173,928 | D | |
| Common Stock, par value $0.01 per shareF1,F2 | Aug 24, 2016 | G | 155 | $0.00 | D | 520,261 | I | By Spouse |
| Common Stock, par value $0.01 per shareF1,F3 | Aug 25, 2016 | G | 11,146 | $0.00 | D | 509,115 | I | By Spouse |
| Common Stock, par value $0.01 per shareF1,F4 | Aug 26, 2016 | G | 62 | $0.00 | D | 509,053 | I | By Spouse |
| Common Stock, par value $0.01 per shareF1,F5 | Aug 30, 2016 | G | 249 | $0.00 | D | 508,804 | I | By Spouse |
| Common Stock, par value $0.01 per shareF1,F6 | Aug 31, 2016 | G | 311 | $0.00 | D | 508,493 | I | By Spouse |
| Common Stock, par value $0.01 per shareF1,F7 | Sep 13, 2016 | G | 162 | $0.00 | D | 508,331 | I | By Spouse |
| Common Stock, par value $0.01 per shareF8,F9 | Nov 7, 2016 | S | 19,692 | $156.30 | D | 488,639 | I | By Spouse |
| Common Stock, par value $0.01 per shareF10,F11 | Nov 7, 2016 | S | 19,194 | $156.29 | D | 15,414 | I | By Limited Liability Co. |
| Common Stock, par value $0.01 per share | holding | — | — | — | 4,435 | I | By 401(k) plan |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Gift, not applicable.
- F10The price reflects a weighted average of sales made at prices ranging from $155.82 to $156.82 per share. The Reporting Person, upon request by the Securities and Exchange Commission staff, the issuer, or a security holder of the issuer, will provide full information regarding the number of shares sold at each separate price for this transaction.
- F11Represents shares held by a limited liability company. Stanley M. Bergman and Marion Bergman, Mr. Bergman's wife, each have voting and dispositive power with respect to the shares held by the limited liability company. Mr. and Mrs. Bergman disclaim beneficial ownership of the shares held by the limited liability company.
- F2Represents (i) 507,684 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 12,577 shares held by Mrs. Bergman. On August 24, 2016, the Bergman Family Trust 2 transferred 12,600 shares to Mrs. Bergman which is reflect in the number in Column 5 of this line item.
- F3Represents (i) 507,684 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 1,431 shares held by Mrs. Bergman.
- F4Represents (i) 507,684 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 1,369 shares held by Mrs. Bergman.
- F5Represents (i) 507,684 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 1,120 shares held by Mrs. Bergman.
- F6Represents (i) 507,684 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 809 shares held by Mrs. Bergman.
- F7Represents (i) 507,684 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 647 shares held by Mrs. Bergman.
- F8The price reflects a weighted average of sales made at prices ranging from $155.87 to $156.81 per share. The Reporting Person, upon request by the Securities and Exchange Commission staff, the issuer, or a security holder of the issuer, will provide full information regarding the number of shares sold at each separate price for this transaction.
- F9Represents (i) 487,992 shares held by the Bergman Family 2010 Trust 2, of which Marion Bergman, Stanley M. Bergman's wife, is a co-trustee and a beneficiary and (ii) 647 shares held by Mrs. Bergman.