SEC Form 4 · accession 0001195734-16-000104
POTBELLY CORP · PBPB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Matthew J Revord
Officer — SVP, GC and Secretary
Period of report
Sep 30, 2016
Accepted (ET)
Sep 30, 2016 · 6:03 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001195734
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Sep 30, 2016 | M | 20,000 | $8.00 | A | 20,000 | D | |
| Common StockF1,F2 | Sep 30, 2016 | S | 20,000 | $12.42 | D | 0 | D | |
| Common Stock | holding | — | — | — | 13,775 | I | by Trust |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Non-Qualified Stock Option (right to buy)F3 | $8.00 | Sep 30, 2016 | M | 20,000 | D | — | Jan 8, 2017 | Common Stock | 20,000 | 30,000 | D |
Explanation of responses
- F1These shares were sold in compliance with a trading plan adopted by the reporting person pursuant to Rule 10b5-1 under the Securities Exchange Act of 1934, as amended.
- F2The Common Stock sold by the Reporting Person and reported herein were sold at a range of $12.26 to $12.52 per share. The sale price reported above represents the weighted average sale price for the reported transaction and has been rounded to the nearest cent.
- F3The stock options vested and became exercisable prior to Potbelly Corporation's initial public offering.