SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
DOYLE J PATRICK

(Last) (First) (Middle)
DOMINO'S PIZZA
30 FRANK LLOYD WRIGHT DRIVE

(Street)
ANN ARBOR MI 48106

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
DOMINOS PIZZA INC [ DPZ ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
President, Domino's USA
3. Date of Earliest Transaction (Month/Day/Year)
06/01/2009
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock, $.01 par value 2,450.492 I 401(K) Savings Plan
Common Stock, $.01 par value 6,076.842(1) D
Common Stock, $.01 par value 06/01/2009 M 2,819 A $0.75 0 D
Common Stock, $.01 par value 06/01/2009 S 2,819 D $9.447(2) 0 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction 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 (Month/Day/Year) 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: 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
Option to Purchase Common Stock $0.75 06/01/2009 M 2,819 06/25/2003 01/24/2010 Common Stock, $.01 par value 2,819 $0 0 D
Option to Purchase Common Stock $14 06/01/2009 D 60,000 (3) 07/13/2014 Common Stock, $.01 par value 60,000 (4) 0 D
Option to Purchase Common Stock $17.11 06/01/2009 D 20,000 (3) 02/18/2015 Common Stock, $.01 par value 20,000 (5) 0 D
Option to Purchase Common Stock $25.02 06/01/2009 D 34,000 (3) 07/29/2015 Common Stock, $.01 par value 34,000 (6) 0 D
Option to Purchase Common Stock $22.46 06/01/2009 D 15,000 (3) 07/26/2016 Common Stock, $.01 par value 15,000 (7) 0 D
Option to Purchase Common Stock $18.39 06/01/2009 D 115,000 (8) 07/18/2017 Common Stock, $.01 par value 115,000 (9) 0 D
Option to Purchase Common Stock $16.94 06/01/2009 D 150,000 (10) 09/14/2017 Common Stock, $.01 par value 150,000 (11) 0 D
Option to Purchase Common Stock $10.06 06/01/2009 A 54,000 06/01/2009 07/13/2014 Common Stock, $.01 par value 54,000 $0 54,000 D
Option to Purchase Common Stock $10.06 06/01/2009 A 18,000 06/01/2009 02/18/2015 Common Stock, $.01 par value 18,000 $0 18,000 D
Option to Purchase Common Stock $12.51 06/01/2009 A 25,500 06/01/2009 07/29/2015 Common Stock, $.01 par value 25,500 $0 25,500 D
Option to Purchase Common Stock $11.23 06/01/2009 A 11,250 06/01/2009 07/26/2016 Common Stock, $.01 par value 11,250 $0 11,250 D
Option to Purchase Common Stock $10.06 06/01/2009 A 103,500 (12) 07/18/2017 Common Stock, $.01 par value 103,500 $0 103,500 D
Option to Purchase Common Stock $10.06 06/01/2009 A 135,000 (13) 09/14/2017 Common Stock, $.01 par value 135,000 $0 135,000 D
Explanation of Responses:
1. Total holdings of shares acquired through Employee Stock Payroll Deduction Plan includes 338.721 shares acquired between May 7, 2009 and June 2, 2009.
2. Sale price of common stock ranged from $9.41 to $9.465 per share.
3. These options to purchase common stock were 100% vested at time of cancellation.
4. On June 1, 2009, the issuer canceled, pursuant to the issuer's stock option exchange program, an option granted to the reporting person on July 13, 2004. In exchange for the option, the reporting person received 54,000 options to purchase common stock.
5. On June 1, 2009, the issuer canceled, pursuant to the issuer's stock option exchange program, an option granted to the reporting person on February 18, 2005. In exchange for the option, the reporting person received 18,000 options to purchase common stock.
6. On June 1, 2009, the issuer canceled, pursuant to the issuer's stock option exchange program, an option granted to the reporting person on July 29, 2005. In exchange for the option, the reporting person received 25,500 options to purchase common stock.
7. On June 1, 2009, the issuer canceled, pursuant to the issuer's stock option exchange program, an option granted to the reporting person on July 26, 2006. In exchange for the option, the reporting person received 11,250 options to purchase common stock.
8. These canceled options to purchase common stock provided for vesting in five equal annual installments starting on July 18, 2008.
9. On June 1, 2009, the issuer canceled, pursuant to the issuer's stock option exchange program, an option granted to the reporting person on July 18, 2007. In exchange for the option, the reporting person received 103,500 options to purchase common stock.
10. These canceled options to purchase common stock provided for vesting in five equal annual installments starting on September 14, 2008.
11. On June 1, 2009, the issuer canceled, pursuant to the issuer's stock option exchange program, an option granted to the reporting person on September 14, 2007. In exchange for the option, the reporting person received 135,000 options to purchase common stock.
12. These options to purchase common stock were vested 20% on the date of grant and the remaining unvested options provide for vesting in four equal annual installments starting on July 18, 2009.
13. These options to purchase common stock were vested 20% on the date of grant and the remaining unvested options provide for vesting in four equal annual installments starting on September 14, 2009.
/s/ Adam J. Gacek, attorney in fact 06/03/2009
** Signature of Reporting Person Date
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).
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