0001195734-23-000103.txt : 20230523
0001195734-23-000103.hdr.sgml : 20230523
20230523165934
ACCESSION NUMBER: 0001195734-23-000103
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230519
FILED AS OF DATE: 20230523
DATE AS OF CHANGE: 20230523
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Head David W
CENTRAL INDEX KEY: 0001500619
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36104
FILM NUMBER: 23949622
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: 1231
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_168487555934094.xml
FORM 4
X0407
4
2023-05-19
0
0001195734
POTBELLY CORP
PBPB
0001500619
Head David W
111 N. CANAL
SUITE 325
CHICAGO
IL
60606
1
0
0
0
0
Common Stock
2023-05-19
4
A
0
16187
0
A
126572
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 on May 19, 2024.
/s/ David Head
2023-05-23