SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person *
H&F Corporate Investors VII, Ltd.

(Last) (First) (Middle)
415 MISSION STREET, SUITE 5700

(Street)
SAN FRANCISCO CA 94105

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Grocery Outlet Holding Corp. [ GO ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
04/27/2020
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 04/27/2020 S 16,743,500 D $ 32.725 (1) 9,799,862 I See Footnote (2)
Common Stock 04/27/2020 J (3) 165,000 D $ 0.00 9,634,862 I See Footnote (2)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person *
H&F Corporate Investors VII, Ltd.

(Last) (First) (Middle)
415 MISSION STREET, SUITE 5700

(Street)
SAN FRANCISCO CA 94105

(City) (State) (Zip)
1. Name and Address of Reporting Person *
Hellman & Friedman Investors VII, L.P.

(Last) (First) (Middle)
415 MISSION STREET, SUITE 5700

(Street)
SAN FRANCISCO CA 94105

(City) (State) (Zip)
1. Name and Address of Reporting Person *
HELLMAN & FRIEDMAN CAPITAL PARTNERS VII (PARALLEL), L.P.

(Last) (First) (Middle)
415 MISSION STREET, SUITE 5700

(Street)
SAN FRANCISCO CA 94105

(City) (State) (Zip)
1. Name and Address of Reporting Person *
H&F Globe Investor GP LLC

(Last) (First) (Middle)
415 MISSION STREET, SUITE 5700

(Street)
SAN FRANCISCO CA 94105

(City) (State) (Zip)
1. Name and Address of Reporting Person *
H&F Globe Investor LP

(Last) (First) (Middle)
415 MISSION STREET, SUITE 5700

(Street)
SAN FRANCISCO CA 94105

(City) (State) (Zip)
Explanation of Responses:
1. This amount represents the $34.00 secondary public offering price per share of the Common Stock of the Issuer less the underwriting discount of $1.275 per share.
2. Reflects securities directly held by H&F Globe Investor LP ("H&F Investor"). The general partner of H&F Investor is H&F Globe Investor GP LLC ("Globe Investor GP"). Hellman & Friedman Capital Partners VII (Parallel), L.P. ("HFCP VII") is the managing member of Globe Investor GP. Hellman & Friedman Investors VII, L.P. ("H&F Investors VII") is the general partner of HFCP VII. H&F Corporate Investors VII, Ltd. ("H&F VII") is the general partner of H&F Investors VII.
3. Represents in-kind distributions of shares of Common Stock previously held by H&F Investor to certain of its direct and indirect partners for the sole purpose of charitable giving.
Remarks:
By: /s/ Erik D. Ragatz, VP of H&F CORPORATE INVESTORS VII, LTD 04/29/2020
By: /s/ Erik D. Ragatz, VP of H&F CORPORATE INVESTORS VII, LTD, GP of HELLMAN & FRIEDMAN INVESTORS VII, L.P. 04/29/2020
By: /s/ Erik D. Ragatz, VP of H&F CORPORATE INVESTORS VII, LTD, GP of HELLMAN & FRIEDMAN INVESTORS VII, L.P., GP of HELLMAN & FRIEDMAN CAPITAL PARTNERS VII (PARALLEL), L.P. 04/29/2020
By: /s/ Erik D. Ragatz, VP of H&F CORPORATE INVESTORS VII, LTD, GP of HELLMAN & FRIEDMAN INVESTORS VII, L.P., GP of HELLMAN & FRIEDMAN CAPITAL PARTNERS VII (PARALLEL), L.P., managing member of H&F GLOBE INVESTOR GP LLC 04/29/2020
By: /s/ Erik D. Ragatz, VP of H&F CORPORATE INVESTORS VII, LTD, GP of HELLMAN & FRIEDMAN INVESTORS VII, L.P., GP of HELLMAN & FRIEDMAN CAPITAL PARTNERS VII (PARALLEL), L.P., managing member of H&F GLOBE INVESTOR GP LLC, GP of H&F GLOBE INVESTOR LP 04/29/2020
** Signature of Reporting Person Date
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