SEC Form 4 · accession 0001209191-18-004876
DOMINOS PIZZA INC · DPZ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Andrew Balson
Director
Period of report
Jan 19, 2018
Accepted (ET)
Jan 23, 2018 · 4:11 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001286681
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, $0.01 par valueF1 | Jan 19, 2018 | M | 9,000 | $10.06 | A | 30,243 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option to Purchase Common Stock | $10.06 | Jan 19, 2018 | M | 9,000 | D | Feb 13, 2009 | Feb 13, 2018 | Common Stock, $0.01 par value | 9,000 | 0 | D |
Explanation of responses
- F1Represents the acquisition of common stock resulting from the exercise and hold of derivative securities reported in Table II.