SEC Form 4 · accession 0001719842-18-000002
National Vision Holdings, Inc. · EYE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John Vaught
Officer — SVP, Chief Information Officer
Period of report
Mar 14, 2018
Accepted (ET)
Mar 16, 2018 · 4:53 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 | Mar 14, 2018 | M | 13,490 | $1.66 | A | 13,490 | D | |
| Common Stock | Mar 14, 2018 | M | 13,455 | $4.27 | A | 26,945 | D | |
| Common Stock | Mar 14, 2018 | F | 9,825 | $33.57 | D | 17,120 | 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)F3 | $1.66 | Mar 14, 2018 | M | 13,490 | D | — | Apr 11, 2023 | Common Stock | 13,490 | 0 | D |
| Stock Option (Right to Buy)F4 | $4.27 | Mar 14, 2018 | M | 13,455 | D | — | Mar 13, 2024 | Common Stock | 13,455 | 26,824 | 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 March 19, 2018.
- F2Represents the withholding of shares to pay the exercise price and related taxes in connection with the stock option exercise.
- F3These stock options are fully vested.
- F4Of these 40,279 stock options, 13,426 are vested and the remaining 26,853 stock options will vest in two equal annual installments on March 13, 2018 and 2019. An additional 100,698 stock options which remain subject to liquidity-event performance-based vesting conditions are not included in the table above.