0001195734-22-000052.txt : 20220506 0001195734-22-000052.hdr.sgml : 20220506 20220505181601 ACCESSION NUMBER: 0001195734-22-000052 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220504 FILED AS OF DATE: 20220505 DATE AS OF CHANGE: 20220505 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: 22898154 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_165178894626834.xml FORM 4 X0306 4 2022-05-04 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 2022-05-04 4 F 0 2264 6.51 D 45812 D Shares withheld for payment of tax liability upon vesting of the restricted stock units granted on April 26, 2021. /s/ Adiya Dixon 2022-05-05