SEC Form 5 · accession 0001209191-19-007724
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
Dec 29, 2018
Accepted (ET)
Feb 6, 2019 · 4:20 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 | Dec 12, 2018 | G | 805 | $0.00 | D | 202,438 | D | |
| Common Stock, par value $0.01 per shareF2 | holding | — | — | — | 877,703 | I | By Spouse | |
| Common Stock, par value $0.01 per share | holding | — | — | — | 9,077 | I | by 401(k) plan |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Gift, not applicable.
- F2Represents (i)877,669 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) 34 shares held by Mrs. Bergman.