SEC Form 4 · accession 0001209191-19-017421

HENRY SCHEIN INC · HSIC

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

Reporting owner

Officer — EVP, Chief Admin. Officer · Director

Period of report

Mar 4, 2019

Accepted (ET)

Mar 6, 2019 · 5:02 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	Mar 4, 2019	D	7,215	$0.00	D	106,816	D
Common Stock, par value $0.01 per share^F1	Mar 4, 2019	F	2,570	$59.76	D	104,246	D
Common Stock, par value $0.01 per share^F2	Mar 5, 2019	A	29,216	$0.00	A	133,462	D
Common Stock, par value $0.01 per share	holding	—	—		—	5,783	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 4, 2016 grant of performance-based restricted stock/units.
F2Grant of restricted stock units (RSU) pursuant to the Issuer's 2013 Stock Incentive Plan. Subject to certain exceptions, 65% will vest subject to (x) Issuer's achievement of a specified performance goal and (y) reporting person's continued perf. of services for the Issuer. 35% will vest subject to (x) passage of a specified period of time and (y) reporting person's continued perf. of services for the Issuer. With respect to the performance-based RSU, if the continued service requirement is satisfied and achievement of the performance goal (x) exceeds 100% of target, the Issuer may issue additional vested shares of common stock in an amount that corresponds to the incremental percentage of the performance goal achieved in excess of 100% of target or (y) is less than 100% of target, the reporting person will surrender to the Issuer shares of common stock in an amount that corresponds to the incremental percentage of the performance goal achieved that is below 100% of target (shortfall).