Statement of Changes in Beneficial Ownership (4)
July 06 2021 - 10:39AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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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1. Name and Address of Reporting Person
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BRIDGEFORD GREGORY M |
2. Issuer Name and Ticker or Trading Symbol
DOLLAR TREE, INC.
[
DLTR
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
500 VOLVO PARKWAY |
3. Date of Earliest Transaction
(MM/DD/YYYY)
7/1/2021 |
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(Street)
CHESAPEAKE, VA 23320
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 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 of Derivative Security: 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 |
| Phantom Stock | (1) | 7/1/2021 | | A (2) | | 638.07 | | (3) | (3) | Common Stock | 638.07 | $99.91 | 638.07 | D | |
| Phantom Stock | (1) | 7/1/2021 | | A (4) | | 750.68 | | (3) | (3) | Common Stock | 750.68 | $99.91 | 750.68 | D | |
| Explanation of Responses: |
| (1) | Each share of phantom stock represents the right to receive one share of Dollar Tree common stock, and cash for any fractional shares. |
| (2) | Represents deferral of director fees under the 2013 Director Deferred Compensation Plan. |
| (3) | Shares of phantom stock are payable in common stock following the earlier of the director's separation from the Board, or the specified date of distribution pursuant to the director's deferral election. |
| (4) | Represents deferral under the 2013 Director Deferred Compensation Plan of the annual director equity award granted from the Issuer's shareholder approved 2021 Omnibus Incentive Plan. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
BRIDGEFORD GREGORY M
500 VOLVO PARKWAY
CHESAPEAKE, VA 23320 | X |
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Signatures
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| /s/ William A. Old, Jr., attorney-in-fact for Mr. Bridgeford | | 7/2/2021 |
| **Signature of Reporting Person | Date |
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