0001437749-14-021434.txt : 20141126 0001437749-14-021434.hdr.sgml : 20141126 20141126161217 ACCESSION NUMBER: 0001437749-14-021434 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141124 FILED AS OF DATE: 20141126 DATE AS OF CHANGE: 20141126 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: 27680 FRANKLIN ROAD CITY: SOUTHFIELD STATE: MI ZIP: 48034 BUSINESS PHONE: (248) 223-9160 MAIL ADDRESS: STREET 1: 27680 FRANKLIN ROAD CITY: SOUTHFIELD STATE: MI ZIP: 48034 FORMER COMPANY: FORMER CONFORMED NAME: Diversified Restaurants Holding, Inc. DATE OF NAME CHANGE: 20070322 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: 141253922 MAIL ADDRESS: STREET 1: 21751 W. ELEVEN MILE ROAD STREET 2: SUITE 208 CITY: SOUTHFIELD STATE: MI ZIP: 48076 4 1 rdgdoc.xml FORM 4 X0306 4 2014-11-24 0001394156 Diversified Restaurant Holdings, Inc. BAGR 0001434679 Ansley T. Michael 27680 FRANKLIN ROAD SOUTHFIELD MI 48034 1 1 1 President and CEO Common Stock 2014-11-24 5 G 0 20000 0 D 11117235 D Common Stock 9000 I By reporting person as UGMA custodian for children 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/ Bradley J. Wyatt, attorney-in-fact 2014-11-26