# EDGAR Filing Document

**Accession Number:** 0001194352
**File Stem:** 0001209191-23-016750
**Filing Date:** 2023-3
**Character Count:** 8020
**Document Hash:** 9b716f21d68bc9889d2e4ca7d642a927
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001209191-23-016750.hdr.sgml**: 20230307

**ACCESSION NUMBER**: 0001209191-23-016750

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230303

**FILED AS OF DATE**: 20230307

**DATE AS OF CHANGE**: 20230307

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** MLOTEK MARK E
- **CENTRAL INDEX KEY:** 0001194352

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 000-27078
- **FILM NUMBER:** 23712999

**MAIL ADDRESS:**
- **STREET 1:** C/O HENRY SCHEIN INC
- **STREET 2:** 135 DURYEA RD
- **CITY:** MELVILLE
- **STATE:** NY
- **ZIP:** 11747
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** HENRY SCHEIN INC
- **CENTRAL INDEX KEY:** 0001000228
- **STANDARD INDUSTRIAL CLASSIFICATION:** WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047]
- **IRS NUMBER:** 113136595
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 135 DURYEA RD
- **CITY:** MELVILLE
- **STATE:** NY
- **ZIP:** 11747
- **BUSINESS PHONE:** 6318435500

**MAIL ADDRESS:**
- **STREET 1:** 135 DURYEA RD
- **CITY:** MELVILLE
- **STATE:** NY
- **ZIP:** 11747

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** SCHEIN HENRY INC
- **DATE OF NAME CHANGE:** 19950907

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>MLOTEK MARK E<br><sub>(Last) (First) (Middle)</sub><br>C/O HENRY SCHEIN, INC.<br>135 DURYEA ROAD<br><sub>(Street)</sub><br>MELVILLE, NY 11747<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-03 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_EVP, Chief Strategic Officer_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>HENRY SCHEIN INC [ HSIC ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock, par value $0.01 per share | 2023-03-03 |  | A |  | 7378<sup>(1)</sup> | A | $0.00 | 112609<sup>(2)</sup> | D |  |
| Common Stock, par value $0.01 per share | 2023-03-03 |  | F |  | 10360<sup>(3)</sup> | D | $78.90 | 102249<sup>(2)</sup> | D |  |
| Common Stock, par value $0.01 per share | 2023-03-03 |  | F |  | 2279<sup>(4)</sup> | D | $78.90 | 99970<sup>(2)</sup> | D |  |
| Common Stock, par value $0.01 per share | 2023-03-03 |  | F |  | 5355<sup>(5)</sup> | D | $78.90 | 94615<sup>(2)</sup> | D |  |
| Common Stock, par value $0.01 per share |  |  |  |  |  |  |  | 870 | I | As Trustee of trusts for the benefit of family members. |
| Common Stock, par value $0.01 per share |  |  |  |  |  |  |  | 4090<sup>(6)</sup> | I | By 401(k) plan |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

---

### Footnotes:

(1) Represents additional shares of the Issuer's common stock issued under the Henry Schein, Inc. 2013 Stock Incentive Plan, (now known as the Henry Schein, Inc. 2020 Stock Incentive Plan) that vested on March 3, 2023 in connection with exceeding the performance target with respect to the reporting person's March 3, 2020 grant of performance-based restricted stock units.

(2) Includes shares of Issuer's common stock held in joint tenancy with reporting person's spouse.

(3) Represents the surrender of shares to the Issuer to satisfy the reporting person's tax withholding obligation upon the vesting of the reporting person's March 3, 2020 grant of performance-based restricted stock units.

(4) Represents the surrender of shares to the Issuer to satisfy the reporting person's tax withholding obligation upon the vesting of the reporting person's March 3, 2021 grant of time-based restricted stock units.

(5) Represents the surrender of shares to the Issuer to satisfy the reporting person's tax withholding obligation upon the vesting of the reporting person's March 5, 2019 grant of time-based restricted stock units. (Actual vesting date of March 5, 2023 was a non-business day so vesting occurred on the preceding business day.)

(6) Reflects the reporting person's interest in equivalent shares of Henry Schein common stock held by the unitized stock fund in the Henry Schein, Inc. 401(k) Savings Plan (the "Plan").  The unitized stock fund consists of Henry Schein common stock and cash or cash equivalents. The number of shares attributed to the reporting person as a participant in the Plan and expressed as equivalent shares has been calculated based on the closing price of Henry Schein common stock on March 3, 2023.

**Signature:** /s/ Jennifer Ferrero (as Attorney-in-Fact for Mark E. Mlotek)  
**Date:** 2023-03-07

### Remarks:

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).

** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

**Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.**