SEC Form 5 · accession 0001209191-18-009676
HENRY SCHEIN INC · HSIC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Donald J Kabat
Director
Period of report
Dec 30, 2017
Accepted (ET)
Feb 13, 2018 · 5:25 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,F2 | Mar 14, 2017 | G | 3,206 | $0.00 | D | 2,168 | D | |
| Common Stock, par value $0.01 per shareF1,F3 | Mar 24, 2017 | G | 3,206 | $0.00 | D | 0 | I | By Trustees |
| Common Stock, par value $0.01 per shareF2,F4 | holding | — | — | — | 18,412 | I | By Trustee |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Gift, not applicable.
- F2On September 14, 2017, the common stock of Henry Schein, Inc. split two-for-one (for shares held on the record date of September 1, 2017), resulting in the reporting person's ownership of additional shares of common stock.
- F3Represents shares held in a trust where Mr. Kabat and his wife are co-trustees for the benefit of Mr. Kabat ("Donald Kabat Trust"). On March 14, 2017, Mr. Kabat transferred 3,206 shares to the Donald Kabat Trust as reflected in the gift reporting in the first row of Table I. This was an administrative error as the shares were intended to be transferred to the a trust where Mr. Kabat and his wife are co-trustees for the benefit of Mrs. Kabat ("Sharon Kabat Trust"). Therefore, on March 24, 2017, the shares were transferred from the Donald Kabat Trust to the Sharon Kabat Trust. As reflected in Column 5 in the third row of Table I.
- F4Represents shares held in the Sharon Kabat Trust (as defined in footnote (3)).