SEC Form 4 · accession 0001195734-17-000034
POTBELLY CORP · PBPB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sherry Ostrowski
Officer — Senior Vice President
Period of report
May 11, 2017
Accepted (ET)
May 15, 2017 · 7:09 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 StockF1 | May 11, 2017 | A | 7,500 | $0.00 | A | 7,500 | D |
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)F4 | $11.05 | May 11, 2017 | A | 18,844 | A | — | May 11, 2027 | Common Stock | 18,844 | 18,844 | D |
Explanation of responses
- F1The common stock is a restricted stock unit which represents a right to receive one share of common stock for each restricted stock unit. Restricted stock units vest in three equal installments on March 7, 2018; March 7, 2019; and March 7, 2020.
- F2Restricted stock unit award pursuant to the Potbelly Corporation 2013 Long-Term Incentive Plan.
- F3Option award pursuant to the Potbelly Corporation 2013 Long-Term Incentive Plan.
- F4The stock options will vest in equal installments on March 7, 2018; March 7, 2019; March 7, 2020; and March 7, 2021.