SEC Form 4 · accession 0001209191-16-149414

HENRY SCHEIN INC · HSIC

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — SVP Corp/Legal Ch of Staff Sec

Period of report

Nov 8, 2016

Accepted (ET)

Nov 10, 2016 · 5:18 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 share^F1	May 18, 2016	G	60	$0.00	D	32,226	D
Common Stock, par value $0.01 per share^F1	Nov 4, 2016	G	40	$0.00	D	32,186	D
Common Stock, par value $0.01 per share	Nov 8, 2016	M	5,250	$59.89	A	37,436	D
Common Stock, par value $0.01 per share^F2	Nov 8, 2016	S	5,250	$158.18	D	32,186	D
Common Stock, par value $0.01 per share	holding	—	—		—	400	I	As trustee of trusts for the benefit of his children
Common Stock, par value $0.01 per share	holding	—	—		—	105	I	By 401(k) plan

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Stock Option (Right to Buy)^F3,F4	$59.89	Nov 8, 2016	M	5,250	D	—	Mar 3, 2018	Common Stock, par value $0.01 per share	5,250	9,128	D

F1Gift, not applicable.
F2The price reflects a weighted average of sales made at prices ranging from $158.17 to $158.23 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.
F3Acquired pursuant to the Issuer's 2013 Stock Incentive Plan, as amended (formerly known as the Henry Schein, Inc. 1994 Stock Incentive Plan).
F4The option vests in four equal installments on each of March 3, 2009, March 3, 2010, March 3, 2011 and March 3, 2012.