SEC Form 4 · accession 0001195734-17-000048
POTBELLY CORP · PBPB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Alan L Johnson
Officer — President and CEO
Period of report
Nov 29, 2017
Accepted (ET)
Dec 1, 2017 · 6:54 pm EST
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 | Nov 29, 2017 | A | 78,125 | $0.00 | A | 78,125 | 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 | $12.80 | Nov 29, 2017 | A | 200,401 | A | — | Nov 29, 2027 | Common Stock | 200,401 | 200,401 | 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 beginning on the first anniversary of the Transaction Date.
- 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 option vests in four equal annual installments beginning on the first anniversary of the Transaction Date.