Statement of Changes in Beneficial Ownership (4)
February 01 2021 - 1:01PM
Edgar (US Regulatory)
FORM 4
[ ]
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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3235-0287
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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
*
BAILEY GEOFFREY R |
2. Issuer Name and Ticker or Trading Symbol
Good Times Restaurants Inc.
[
GTIM
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
141 UNION BLVD., STE 400 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
1/28/2021 |
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(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 | 1/28/2021 | | A(1) | | 3237 | A | $2.78 | 48099 | 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 | | | | | | | 11/16/2020 (2) | 11/16/2021 | Common Stock | 913 | | 914 | D | |
| Restricted Stock Units | $0.00 | | | | | | | 6/27/2020 (3) | 6/27/2021 | Common Stock | 1615 | | 1615 | D | |
| Non-Qualified Stock Options | $1.56 | | | | | | | 12/13/2010 (4) | 12/13/2020 | Common Stock | 666 | | 4108 | D | |
| Non-Qualified Stock Options | $1.31 | | | | | | | 12/14/2011 (5) | 12/14/2021 | Common Stock | 5000 | | 9108 | D | |
| Non-Qualified Stock Options | $2.31 | | | | | | | 1/2/2013 (6) | 1/2/2023 | Common Stock | 2000 | | 11108 | D | |
| Non-Qualified Stock Options | $2.44 | | | | | | | 9/27/2013 (7) | 9/27/2023 | Common Stock | 5000 | | 16108 | D | |
| Non-Qualified Stock Options | $5.29 | | | | | | | 11/23/2015 (8) | 11/23/2025 | Common Stock | 3781 | | 19889 | D | |
| Non-Qualified Stock Options | $4.25 | | | | | | | 7/23/2018 (9) | 7/23/2028 | Common Stock | 2715 | | 22604 | D | |
| Explanation of Responses: |
| (1) | The reporting person received a discretionary grant of common stock. |
| (2) | The Reporting Person was granted 2,740 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 |
| (3) | The Reporting Person was granted 4,865 Restricted Stock Units ("RSU") on June 27, 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. |
| (4) | The Reporting Person was granted 666 (post-split reflected) Non-Qualified Stock Options (Right to Buy) on December 13, 2010 vesting at 1/5 of the total amount granted over five years. |
| (5) | The Reporting Person was granted 5,000 Non-Qualified Stock Options (Right to Buy) on December 14, 2011 vesting at 1/5 of the total amount granted over five years. |
| (6) | The Reporting Person was granted 2,000 Non-Qualified Stock Options (Right to Buy) on January 1, 2013 vesting at 1/5 of the total amount granted over five years. |
| (7) | The Reporting Person was granted 5,000 Non-Qualified Stock Options (Right to Buy) on September 27, 2013 vesting at 1/5 of the total amount granted over five years. |
| (8) | The Reporting Person was granted 3,781 Non-Qualified Stock Options (Right to Buy) on November 23, 2015 vesting at 1/5 of the total amount granted over five years. |
| (9) | The Reporting Person was granted 2,715 Non-Qualified Stock Options (Right to Buy) on July 23, 2018 vesting at 1/5 of the total amount granted over five years. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
BAILEY GEOFFREY R
141 UNION BLVD., STE 400
LAKEWOOD, CO 80228 | X |
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Signatures
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| Geoffrey R. Bailey | | 1/28/2021 |
| **Signature of Reporting Person | Date |
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