-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, V33lnSvehGYhTPKtpw+TFZH4rMMJwn1yZepuz4z8u5LTTzyIrMdM3U+9QEqB6cJA DxrfLPmUTEvwJdTahpDqrQ== 0001179110-03-010918.txt : 20031118 0001179110-03-010918.hdr.sgml : 20031118 20031118165729 ACCESSION NUMBER: 0001179110-03-010918 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031117 FILED AS OF DATE: 20031118 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FAMOUS DAVES OF AMERICA INC CENTRAL INDEX KEY: 0001021270 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 411782300 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7657 ANAGRAM DR CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 BUSINESS PHONE: 612-557-57 MAIL ADDRESS: STREET 1: 7657 ANAGRAM DR CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JEFFRIES MARY L CENTRAL INDEX KEY: 0001262160 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21625 FILM NUMBER: 031010959 BUSINESS ADDRESS: STREET 1: FAMOUS DAVE'S OF AMERICA INC STREET 2: 8091 WALLACE RD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 BUSINESS PHONE: 952294300 MAIL ADDRESS: STREET 1: FAMOUS DAVE'S OF AMERICA INC STREET 2: 8091 WALLACE RD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 4 1 edgar.xml FORM 4 - X0201 4 2003-11-17 0 0001021270 FAMOUS DAVES OF AMERICA INC DAVE 0001262160 JEFFRIES MARY L C/O FAMOUS DAVE'S OF AMERICA, INC. 8091 WALLACE ROAD EDEN PRAIRIE MN 55344 1 0 0 0 Common Stock, $.01 par value 2003-11-17 4 P 0 1000 4.97 A 1000 D Common Stock, $.01 par value 2003-11-17 4 P 0 1035 4.98 A 2035 D Director Stock Option Pursuant to Rule 16b-3 (right to buy) 6 2004-06-13 2013-06-13 Common Stock, $.01 par value 25000 25000 D /s/ Mary L. Jeffries 2003-11-18 -----END PRIVACY-ENHANCED MESSAGE-----