SEC Form 4 · accession 0001261163-18-000006
National Vision Holdings, Inc. · EYE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jeff Busbee
Officer — SVP, Chief HR Officer
Period of report
Jul 25, 2018
Accepted (ET)
Jul 27, 2018 · 4:26 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001710155
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Jul 25, 2018 | M | 24,514 | $4.27 | A | 90,357 | D | |
| Common Stock | Jul 25, 2018 | M | 16,345 | $7.25 | A | 106,702 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy)F2 | $4.27 | Jul 25, 2018 | M | 24,514 | D | — | Mar 13, 2024 | Common Stock | 24,514 | 41,397 | D |
| Stock Option (Right to Buy)F3 | $7.25 | Jul 25, 2018 | M | 16,345 | D | — | Mar 13, 2024 | Common Stock | 16,345 | 0 | D |
Explanation of responses
- F1Represents an exercise of stock options in connection with the Reporting Person's sale of shares of common stock received upon exercise in a secondary offering that is scheduled to be completed on July 30, 2018.
- F2Of this stock option award, 43,941 are vested and the remaining 21,970 stock options will vest on March 13, 2019. An additional 164,778 stock options which remain subject to liquidity-event performance-based vesting conditions are not included in the table above.
- F3These stock options are fully vested.