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