Statement of Changes in Beneficial Ownership (4)
November 20 2019 - 03:15PM
Edgar (US Regulatory)
FORM 4
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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).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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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1. Name and Address of Reporting Person
*
Zink Ryan M |
2. Issuer Name and Ticker or Trading Symbol
Good Times Restaurants Inc.
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GTIM
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Acting CEO, CFO, Treasurer |
(Last)
(First)
(Middle)
141 UNION BOULEVARD #400 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
11/16/2019 |
(Street)
LAKEWOOD, CO 80228
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 11/18/2019 | | M(1) |
V
| 4340 | A | $0.00 | 50565 | D | |
Common Stock | 11/18/2019 | | F(2) |
V
| 1219 | D | $1.74 | 49346 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 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 of Derivative Security: 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 |
Restricted Stock Units | $0.00 | 11/18/2019 | | M |
V
| | 4340 | 11/16/2019 (1) | 11/18/2021 | Common Stock | 4340 | $0.00 | 8681 | D | |
Restricted Stock Units | $0.00 | | | | | | | 9/27/2017 (3) | 9/27/2020 | Common Stock | 12345 | | 21026 | D | |
Incentive Stock Options (Right to buy) | $5.00 | | | | | | | 10/12/2018 (4) | 10/12/2028 | Common Stock | 15000 | | 15000 | D | |
Incentive Stock Options (Right to buy) | $4.66 | | | | | | | 11/16/2018 (5) | 11/16/2028 | Common Stock | 12876 | | 27876 | D | |
Explanation of Responses: |
(1) | Represents the conversion upon vesting of Restricted Stock Units into common stock (the "Converted Common Stock. The Reporting Person was granted 13,021 Restricted Stock Units on November 16, 2018 vesting at 1/3 of the total granted amount over three years. Such Restricted Stock Units were previously reported in Table II on a Form 4 filed with the Securities and Exchange Commission. |
(2) | Represents shares withheld to cover the exercise price of the options exercised. |
(3) | The Reporting Person was granted 12,345 Restricted Stock Units on September 27, 2017 vesting at 1/3 of the total granted amount over three years. Suck Restricted Stock Units were previously reported in Table II on a Form 4 filed with the Securities and Exchange Commission. |
(4) | The reporting person was granted 15,000 Incentive Stock Options on October 12, 2018 vesting at 1/5 of the total granted amount over five years. Such restricted stock units were previously reported in Table II on a Form 4 filed with the Securities and Exchange Commission. |
(5) | The reporting person was granted 12,876 Incentive Stock Options on November 16, 2018 vesting at 1/5 of the total granted amount over five years. Such restricted stock units were previously reported in Table II on a Form 4 filed with the Securities and Exchange Commission. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Zink Ryan M 141 UNION BOULEVARD #400 LAKEWOOD, CO 80228 |
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| Acting CEO, CFO, Treasurer |
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Signatures
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/s/ Ryan M. Zink | | 11/20/2019 |
**Signature of Reporting Person | Date |
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