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
|
05/04/2007(3)
|
07/01/2013 |
Common Stock, $.01 par value
|
11,666
|
$
8.66
|
D
|
Â
|
Option to purchase Common Stock
|
07/13/2009(4)
|
07/13/2014 |
Common Stock, $.01 par value
|
3,200
|
$
2.75
(8)
|
D
|
Â
|
Option to purchase Common Stock
|
07/13/2009(4)
|
07/13/2014 |
Common Stock, $.01 par value
|
4,800
|
$
14
|
D
|
Â
|
Option to purchase Common Stock
|
07/29/2010(5)
|
07/29/2015 |
Common Stock, $.01 par value
|
3,000
|
$
11.52
(8)
|
D
|
Â
|
Option to purchase Common Stock
|
07/29/2010(5)
|
07/29/2015 |
Common Stock, $.01 par value
|
2,000
|
$
25.02
|
D
|
Â
|
Option to purchase Common Stock
|
07/26/2011(6)
|
07/26/2016 |
Common Stock, $.01 par value
|
6,400
|
$
8.96
(8)
|
D
|
Â
|
Option to purchase Common Stock
|
07/26/2011(6)
|
07/26/2016 |
Common Stock, $.01 par value
|
1,600
|
$
22.46
|
D
|
Â
|
Option to purchase Common Stock
|
07/18/2012(7)
|
07/18/2017 |
Common Stock, $.01 par value
|
15,000
|
$
18.39
|
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) |
Total shares held in Domino's Pizza, Inc. stock fund, part of the Domino's Pizza 401(k) savings plan. |
(2) |
Total shares acquired through Employee Stock Payroll Deduction Plan. |
(3) |
The vesting schedule for the options to purchase common stock was accelerated to be fully exercisable on May 4, 2007 in connection with the Domino's Pizza, Inc. recapitalization. No new options to purchase common stock were granted. |
(4) |
The options to purchase common stock vest 20% each year on the anniversary of the option to purchase grant date. Thus 20% vested on each of July 13, 2005, July 13, 2006 and July 13, 2007 and an additional 20% shall vest on each of July 13, 2008 and July 13, 2009. |
(5) |
The options to purchase common stock vest 20% each year on the anniversary of the option to purchase grant date. Thus 20% vested on each of July 29, 2006,and July 29, 2007 and an additional 20% shall vest on each of July 29, 2008, July 29, 2009 and July 29, 2010. |
(6) |
The options to purchase common stock vest 20% each year on the anniversary of the option to purchase grant date. Thus 20% vested on July 26, 2007 and an additional 20% shall vest on each of July 13, 2008, July 13, 2009, July 13, 2010 and July 13, 2011. |
(7) |
The options to purchase common stock vest 20% each year on the anniversary of the option to purchase grant date. Thus 20% shall vest on each of July 18, 2008, July 18, 2009, July 18, 2010, July 13, 2011 and July 13, 2012. |
(8) |
Reflects adjustment to previously granted stock option awards under the Domino's Pizza, Inc. 2004 Equity Incentive Plan in connection with the special dividend of $13.50 per share of Common Stock of Domino's Pizza, Inc. payable on May 4, 2007 to shareholders of record on April 27, 2007. The exercise price of the stock options was adjusted by the amount of the dividend, or by such lesser amount required by law. |