1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security |
5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Option to Purchase Common Stock
|
07/18/2012 |
07/18/2017 |
Common Stock, $0.01 par value
|
10,800
|
$
10.06
|
D
|
Â
|
Option to Purchase Common Stock
|
07/16/2012 |
07/16/2019 |
Common Stock, $0.01 par value
|
4,000
|
$
7.97
|
D
|
Â
|
Option to Purchase Common Stock
|
07/18/2012 |
07/18/2017 |
Common Stock, $0.01 par value
|
2,700
|
$
10.06
|
D
|
Â
|
Option to Purchase Common Stock
|
07/16/2013 |
07/16/2018 |
Common Stock, $0.01 par value
|
9,600
|
$
10.88
|
D
|
Â
|
Option to Purchase Common Stock
|
07/16/2013 |
07/16/2018 |
Common Stock, $0.01 par value
|
4,000
|
$
10.88
|
D
|
Â
|
Option to Purchase Common Stock
|
07/16/2013 |
07/16/2018 |
Common Stock, $0.01 par value
|
2,400
|
$
7.88
|
D
|
Â
|
Option to Purchase Common Stock
|
07/16/2013 |
07/16/2018 |
Common Stock, $0.01 par value
|
1,000
|
$
7.88
|
D
|
Â
|
Option to Purchase Common Stock
|
07/17/2017(7)
|
07/17/2023 |
Common Stock, $0.01 par value
|
1,470
|
$
63.05
|
D
|
Â
|
Option to Purchase Common Stock
|
07/16/2018(8)
|
07/16/2024 |
Common Stock, $0.01 par value
|
2,630
|
$
73.04
|
D
|
Â
|
Option to Purchase Common Stock
|
07/15/2019(9)
|
07/15/2025 |
Common Stock, $0.01 par value
|
2,060
|
$
118.54
|
D
|
Â
|
Option to Purchase Common Stock
|
07/15/2019(9)
|
07/15/2025 |
Common Stock, $0.01 par value
|
9,070
|
$
118.54
|
D
|
Â
|
* |
If the form is filed by more than one reporting person, see Instruction 5(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). |
(1) |
Includes 823.345 shares acquired under the Domino's Employee Stock Payroll Deduction Plan. |
(2) |
Includes 890 shares of common stock representing two-fourths of an original grant of performance-based restricted stock that shall vest one-half on each of July 17, 2016 and July 17, 2017 if applicable performance conditions are achieved. |
(3) |
Includes 1,060 shares of common stock representing two-fourths of an original grant of performance-based restricted stock that shall vest one-half on each of February 27, 2016 and February 27, 2017 if applicable performance conditions are achieved. |
(4) |
Includes 1,133 shares of common stock representing three-fourths of an original grant of performance-based restricted stock that shall vest one-third on each of July 16, 2016, July 16, 2017 and July 16, 2018 if applicable performance conditions are achieved. |
(5) |
Includes 960 shares of common stock representing a grant of performance-based restricted stock that shall vest one-fourth on each of July 15, 2016, July 15, 2017, July 15, 2018 and July 15, 2019 if applicable performance conditions are achieved. |
(6) |
Includes 2,110 shares of common stock representing a grant of performance-based restricted stock that shall vest one-fourth on each of July 15, 2016, July 15, 2017, July 15, 2018 and July 15, 2019 if applicable performance conditions are achieved. |
(7) |
The options to purchase common stock vest one-fourth each year on the anniversary date of the grant date. Thus, one-fourth vested on each of July 17, 2014 and July 17, 2015, and one-fourth shall vest on each of July 17, 2016 and July 17, 2017. |
(8) |
The options to purchase common stock vest one-fourth each year on the anniversary date of the grant date. Thus, one-fourth vested on July 16, 2015, and one-fourth shall vest on each of July 16, 2016, July 16, 2017 and July 16, 2018. |
(9) |
The options to purchase common stock vest one-fourth each year on the anniversary date of the grant date. Thus, one-fourth shall vest on each of July 15, 2016, July 15, 2017, July 15, 2018 and July 15, 2019. |