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