SEC Form 4 · accession 0001209191-19-016524

HENRY SCHEIN INC · HSIC

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

Reporting owner

Officer — EVP, Chief Financial Officer · Director

Period of report

Mar 1, 2019

Accepted (ET)

Mar 5, 2019 · 4:33 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,F2	Mar 1, 2019	F	3,226	$60.07	D	167,514	D
Common Stock, par value $0.01 per share	holding	—	—		—	6,684	I	by 401(k) plan

No Table II lines on this filing.

F1Represents the surrender of shares to the Issuer to satisfy the reporting person's tax withholding obligation upon the vesting of the reporting person's March 3, 2015 grant of time-based restricted stock/units. (Actual vesting date of March 3, 2019 was a non-business day so vesting occurred on the preceding business day.)
F2The number of restricted stock/units included in Column 5 of Table 1 was adjusted in connection with the spin-off and subsequent merger of the Issuer's animal health business on February 7, 2019 (the "Spin-Off"). The adjustment reflects the product of (i) the number of restricted stock/unit awards immediately prior to the Spin-Off and (ii) a ratio equal to a fraction, with the numerator equal to the average of the high and low pre-Spin-Off trading prices of the Issuer's common stock on February 6, 2019 (the "Issuer Pre-Spin-Off Price") and the denominator equal to the difference between (A) the Issuer Pre-Spin-Off Price and (B) the product of (x) 0.4 and (y) the average of the high and low trading prices of the common stock of Covetrus, Inc. (the combined company resulting from the Spin-Off) on February 8, 2019, the trading day immediately following the distribution date of the Spin-Off.