0000899243-19-022672.txt : 20190903 0000899243-19-022672.hdr.sgml : 20190903 20190903165035 ACCESSION NUMBER: 0000899243-19-022672 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20190823 FILED AS OF DATE: 20190903 DATE AS OF CHANGE: 20190903 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Head David W CENTRAL INDEX KEY: 0001500619 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36104 FILM NUMBER: 191072535 MAIL ADDRESS: STREET 1: 4311 SNEED ROAD CITY: NASHVILLE STATE: TN ZIP: 37215 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: POTBELLY CORP CENTRAL INDEX KEY: 0001195734 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 364466837 FISCAL YEAR END: 1230 BUSINESS ADDRESS: STREET 1: 111 N. CANAL STREET 2: SUITE 850 CITY: CHICAGO STATE: IL ZIP: 60606 BUSINESS PHONE: 3129510600 MAIL ADDRESS: STREET 1: 111 N. CANAL STREET 2: SUITE 850 CITY: CHICAGO STATE: IL ZIP: 60606 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2019-08-23 1 0001195734 POTBELLY CORP PBPB 0001500619 Head David W 111 N. CANAL SUITE 850 CHICAGO IL 60606 1 0 0 0 Exhibit List 1. Exhibit 24 - Power of Attorney /s/ Matthew J. Revord For: David W. Head 2019-09-03 EX-24.1 2 attachment1.htm EX-24.1 DOCUMENT
                                                                    Exhibit 24.1

                              POTBELLY CORPORATION

                               POWER OF ATTORNEY


APPOINTMENT of Attorney-in-Fact.  Be it known to all that the undersigned, David
W. Head, hereby constitutes and appoints each of Matthew Revord and Xuehui
Zhang, signing singly, to be my true and lawful Attorney-in-Fact to:

     (1)  execute for and on my behalf, in my capacity as an officer and/or
          director of Potbelly Corporation, (the "Company"), Forms 3, 4, and 5
          (including amendments thereto) in accordance with Section 16(a) of the
          Securities Exchange Act of 1934 and the rules and regulations
          thereunder;

     (2)  do and perform any and all acts for and on my behalf which may be
          necessary or desirable to complete and execute any such Forms 3, 4 or
          5 and timely file such forms (including amendments thereto) and
          application with the United States Securities and Exchange Commission
          and any stock exchange or similar authority; and

     (3)  take any other action of any type whatsoever in connection with the
          foregoing which, in the opinion of the General Counsel, may be of
          benefit to, in the best interest of, or legally required by me, it
          being understood that the documents executed by such attorney-in-fact
          on my behalf pursuant to this Power of Attorney shall be in such form
          and shall contain such terms and conditions as in the General
          Counsel's discretion.

The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that such attorney-in-fact shall lawfully do
or cause to be done by virtue of this power of attorney and the rights and
powers herein granted. The undersigned acknowledges that the attorneys-in-fact,
in serving in such capacity at the request of the undersigned, are not assuming,
nor is the Company assuming, any of the undersigned's responsibilities to comply
with Section 16 of the Securities Exchange Act of 1934.

The undersigned agrees that each such attorney-in-fact herein may rely entirely
on information furnished orally or in writing by the undersigned, or the
undersigned's agent to such attorney-in- fact. The undersigned also agrees to
indemnify and hold harmless the Company and each such attorney-in-fact against
any losses, claims, damages or liabilities (or actions in these respects) that
arise out of or are based upon any untrue statements or omission of necessary
facts in the information provided by the undersigned or the undersigned's agent
to such attorney-in fact for purposes of executing, acknowledging, delivering or
filing Forms 3, 4 or 5 (including amendments thereto) and agrees to reimburse
the Company and such attorney-in-fact for any legal or other expenses reasonably
incurred in connection with investigating or defending against any such loss,
claim, damage, liability or action.

This Power of Attorney supersedes any power of attorney previously executed by
the undersigned and the authority of the attorneys-in-fact named in any prior
powers of attorney is hereby revoked.

DURATION.  This Power of Attorney shall remain in full force and effect until
the undersigned is no longer required to file Forms 3, 4 or 5 with respect to
the undersigned's holdings of and transactions in securities issued by the
Company, unless earlier (a) revoked by the undersigned in a signed writing
delivered to the foregoing attorneys-in-fact or (b) superseded by a new power of
attorney regarding the purposes outlined in the first paragraph hereof dated as
of a later date.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 30th day of August, 2019.


                                  /s/ David W. Head
                                  ----------------------------
                                  David W. Head