SEC Form 4 · accession 0002083688-26-000005
National Vision Holdings, Inc. · EYE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Ana Moeddel
Officer — CHIEF MERCH. & MC OFFICER
Period of report
Sep 2, 2026
Accepted (ET)
Sep 3, 2026 · 4:15 pm EDT
Rule 10b5-1 plan
box not checked
Issuer CIK
0001710155
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Sep 2, 2026 | M | 11,395 | — | A | 12,822 | D | |
| Common StockF3 | Sep 2, 2026 | F | 3,114 | $16.82 | D | 9,708 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitsF1,F4 | — | Sep 2, 2026 | M | 11,395 | D | — | — | Common Stock | 11,395 | 33,543 | D |
Explanation of responses
- F1Restricted stock units convert into common stock on a one-for-one basis.
- F2Includes 1,427 shares acquired under the 2018 Associate Stock Purchase Plan.
- F3Reflects payment of tax liability by withholding securities incident to vesting of restricted stock units.
- F4On September 2, 2025, the reporting person was granted 34,185 restricted stock units, vesting in three equal installments beginning on the first anniversary of the grant date.