Filing Details

Accession Number:
0001140361-17-040309
Form Type:
4
Zero Holdings:
No
Publication Time:
2017-10-31 16:37:40
Reporting Period:
2017-08-14
Accepted Time:
2017-10-31 16:37:40
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1710155 National Vision Holdings Inc. EYE Ophthalmic Goods (3851) 464841717
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1719311 J. Raymond Mcallister C/O National Vision Holdings, Inc.
2435 Commerce Avenue, Bldg. 2200
Duluth GA 30096-4980
Chief Operating Officer No No No No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2017-08-14 63,572 $15.73 63,572 No 4 A Direct
Common Stock Acquisiton 2017-10-30 11,200 $22.00 74,772 No 4 P Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 A Direct
No 4 P Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Stock Option (Right to Buy) Acquisiton 2017-08-14 144,927 $0.00 144,927 $15.74
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
144,927 2027-08-14 No 4 A Direct
Footnotes
  1. Reported on a post 1.96627-for-one reverse stock split basis effective October 24, 2017.
  2. Reflects shares of common stock purchased under the Issuer's Directed Share Program in connection with the Issuer's initial public offering.
  3. Represents a grant of stock options which will vest in five equal annual installments beginning on August 14, 2018. An additional 217,390 stock options which remain subject to liquidity-event performance-based vesting conditions are not included in the table above.