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
|
06/01/2012 |
09/22/2018 |
Common Stock, $.001 par value
|
45,000
|
$
7.06
|
D
|
Â
|
Option to Purchase Common Stock
|
09/22/2012 |
09/22/2018 |
Common Stock, $0.01 par value
|
180,000
|
$
10.06
|
D
|
Â
|
Option to Purchase Common Stock
|
07/16/2012 |
07/16/2019 |
Common Stock, $0.01 par value
|
30,000
|
$
7.97
|
D
|
Â
|
Option to Purchase Common Stock
|
07/20/2013 |
07/20/2020 |
Common Stock, $0.01 par value
|
8,334
|
$
9.32
|
D
|
Â
|
Option to Purchase Common Stock
|
07/20/2012 |
07/20/2020 |
Common Stock, $0.01 par value
|
16,666
|
$
12.32
|
D
|
Â
|
Option to Purchase Common Stock
|
07/20/2014 |
07/20/2021 |
Common Stock, $0.01 par value
|
10,000
|
$
22.78
|
D
|
Â
|
Option to Purchase Common Stock
|
07/20/2012 |
07/20/2021 |
Common Stock, $0.01 par value
|
5,000
|
$
25.78
|
D
|
Â
|
Option to Purchase Common Stock
|
07/20/2015(7)
|
07/20/2022 |
Common Stock, $0.01 par value
|
9,690
|
$
32.69
|
D
|
Â
|
Option to Purchase Common Stock
|
02/27/2017(8)
|
02/27/2023 |
Common Stock, $0.01 par value
|
37,020
|
$
46.83
|
D
|
Â
|
Option to Purchase Common Stock
|
07/17/2017(9)
|
07/17/2023 |
Common Stock, $0.01 par value
|
17,110
|
$
63.05
|
D
|
Â
|
Option to Purchase Common Stock
|
07/16/2018(10)
|
07/16/2024 |
Common Stock, $0.01 par value
|
15,960
|
$
73.04
|
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 3,827 shares of common stock representing one-third of an original grant of performance-based restricted stock that shall vest on July 20, 2015 if applicable performance conditions are achieved. |
(2) |
Includes 3,870 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 17, 2015, July 17, 2016 and July 17, 2017 if applicable performance conditions are achieved. |
(3) |
Includes 8,768 shares of common stock representing three-fourths of an original grant of performance-based restricted stock that shall vest one-third on each of February 27, 2015, February 27, 2016 and February 27, 2017 if applicable performance conditions are achieved. |
(4) |
Includes 4,590 shares of common stock representing a grant of performance-based restricted stock that shall vest one-fourth on each of July 16, 2015, July 16, 2016, July 16, 2017 and July 16, 2018 if applicable performance conditions are achieved. |
(5) |
Includes 362.634 shares held in Domino's Employee Stock Payroll Deduction Plan. |
(6) |
Total shares held in the Domino's Pizza 401(k) Savings Plan. |
(7) |
The options to purchase common stock vest one-third each year on the anniversary date of the grant date. Thus, one-third vested on each of July 20, 2013 and July 20, 2014, and one-third shall vest on July 20, 2015. |
(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 February 27, 2014, and one-fourth shall vest on each of February 27, 2015, February 27, 2016 and February 27, 2017. |
(9) |
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 17, 2014, and one-fourth shall vest on each of July 17, 2015, July 17, 2016 and July 17, 2017. |
(10) |
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 16, 2015, July 16, 2016, July 16, 2017 and July 16, 2018. |