0001195734-22-000030.txt : 20220407
0001195734-22-000030.hdr.sgml : 20220407
20220407183047
ACCESSION NUMBER: 0001195734-22-000030
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220401
FILED AS OF DATE: 20220407
DATE AS OF CHANGE: 20220407
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Dixon Adiya
CENTRAL INDEX KEY: 0001838731
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36104
FILM NUMBER: 22814955
MAIL ADDRESS:
STREET 1: 111 N CANAL
STREET 2: SUITE 850
CITY: CHICAGO
STATE: IL
ZIP: 60606
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 325
CITY: CHICAGO
STATE: IL
ZIP: 60606
BUSINESS PHONE: 3129510600
MAIL ADDRESS:
STREET 1: 111 N. CANAL
STREET 2: SUITE 325
CITY: CHICAGO
STATE: IL
ZIP: 60606
4
1
wf-form4_164937063269011.xml
FORM 4
X0306
4
2022-04-01
0
0001195734
POTBELLY CORP
PBPB
0001838731
Dixon Adiya
111 N. CANAL
SUITE 325
CHICAGO
IL
60606
0
1
0
0
SVP, CLO and Secretary
Common Stock
2022-04-01
4
A
0
22866
0
A
48076
D
Performance Stock Units
2022-04-01
4
A
0
22865
0
A
Common Stock
22865.0
22865
D
Represents an award of restricted stock units. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock. These restricted stock units vest in equal installments on April 1, 2023, April 1, 2024 and April 1, 2025.
Represents an award of performance stock units which vest based on performance versus certain metrics as described in the award agreement.
/s/ Adiya Dixon
2022-04-07