0001394156-20-000024.txt : 20200302
0001394156-20-000024.hdr.sgml : 20200302
20200302122044
ACCESSION NUMBER: 0001394156-20-000024
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200225
FILED AS OF DATE: 20200302
DATE AS OF CHANGE: 20200302
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ansley T. Michael
CENTRAL INDEX KEY: 0001434679
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35881
FILM NUMBER: 20675609
MAIL ADDRESS:
STREET 1: 21751 W. ELEVEN MILE ROAD
STREET 2: SUITE 208
CITY: SOUTHFIELD
STATE: MI
ZIP: 48076
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Diversified Restaurant Holdings, Inc.
CENTRAL INDEX KEY: 0001394156
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812]
IRS NUMBER: 030606420
STATE OF INCORPORATION: NV
FISCAL YEAR END: 1227
BUSINESS ADDRESS:
STREET 1: 5750 NEW KING DR.
STREET 2: SUITE 320
CITY: TROY
STATE: MI
ZIP: 48098
BUSINESS PHONE: (833) 374-7282
MAIL ADDRESS:
STREET 1: 5750 NEW KING DR.
STREET 2: SUITE 320
CITY: TROY
STATE: MI
ZIP: 48098
FORMER COMPANY:
FORMER CONFORMED NAME: Diversified Restaurants Holding, Inc.
DATE OF NAME CHANGE: 20070322
4
1
wf-form4_158316962672745.xml
FORM 4
X0306
4
2020-02-25
1
0001394156
Diversified Restaurant Holdings, Inc.
SAUC
0001434679
Ansley T. Michael
5750 NEW KING DRIVE
SUITE 320
TROY
MI
48098
1
1
1
0
President & CEO
Common Stock
2020-02-25
4
D
0
2214557
1.05
D
0
D
Common Stock
2020-02-25
4
D
0
8000000
1.05
D
0
I
By reporting person and wife through family limited liability company
Common Stock
2020-02-25
4
D
0
9000
1.05
D
0
I
By reporting person as UGMA custodian for children
Disposed of pursuant to merger agreement between the issuer and Patton Wings Intermediate Holdings, LLC for $1.05 per share in cash on the effective date of the merger.
Reporting person transferred these shares to a family limited liability company of which the reporting person is the sole voting member with sole dispositive power over the shares, and the reporting person and his wife are the sole beneficial owners.
The reporting person disclaims beneficial ownership of these shares and this report shall not be deemed an admission that the reporting person is the beneficial owner of these shares for purposes of Section 16 or for any other purpose
/s/ Stacy C. Spence, Attorney-in-Fact
2020-02-25