FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
GRANITE CITY FOOD & BREWERY LTD [ GCFB ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 06/30/2003 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 06/30/2003 | J(1) | V | 51,260 | A | $0 | 51,260 | I | see footnote(5) | |
Common Stock | 09/30/2003 | J(1) | V | 51,260 | A | $0 | 102,520 | I | see footnote(5) | |
Common Stock | 12/31/2003 | J(1) | V | 51,260 | A | $0 | 153,780 | I | see footnote(5) | |
Common Stock | 03/31/2004 | J(1) | V | 51,260 | A | $0 | 205,040 | I | see footnote(5) | |
Common Stock | 08/06/2004 | J(2) | 98,489 | D | $0 | 106,551 | I | see footnote(6) | ||
Common Stock | 08/06/2004 | J(3) | 3,390 | A | $0 | 109,941 | D | |||
Common Stock | 08/06/2004 | J(4) | 5,829 | A | $0 | 115,770 | I | see footnote(7) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) | 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: 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 |
Explanation of Responses: |
1. Dividend from Issuer to Brew Buddies, L.L.C. and Bluestem Capital Partners III Limited Partnership. |
2. Pro-rata Distribution from Brew Buddies, L.L.C. to its members. |
3. Distribution received by Reporting Person from Brew Buddies, L.L.C. pursuant to the distribution discussed in F2. |
4. Distribution received by Brew Masters, L.L.C. from Brew Buddies, L.L.C. pursuant to the distribution discussed in F2. |
5. Represents securities held by Brew Buddies, L.L.C. and Bluestem Capital Partners III Limited Partnership. |
6. Represents securities held by Brew Buddies, L.L.C. |
7. Consists of (a) 101,248 shares received by Bluestem Capital Partners III Limited Partnership in the dividend referred to in footnote 1, (b) 5,303 shares retained by Brew Buddies, L.L.C. after the distribution referred to in footnote 2, and (c) 5,829 shares received by Brew Masters, LLC pursuant to the distribution referred to in footnote 2. |
Remarks: |
Mr. Kirby has business relationships with Brew Buddies, L.L.C., Bluestem Capital Partners III Limited Partnership and Brew Masters, LLC, such that he may be deemed to be the indirect beneficial owner of the securities held by such entities. This report includes securities held by such entities. |
Steven T. Kirby | 08/11/2004 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |