0000809248-21-000146.txt : 20211006 0000809248-21-000146.hdr.sgml : 20211006 20211006164958 ACCESSION NUMBER: 0000809248-21-000146 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211005 FILED AS OF DATE: 20211006 DATE AS OF CHANGE: 20211006 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DiGenova Gerald J CENTRAL INDEX KEY: 0001574550 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33174 FILM NUMBER: 211310220 MAIL ADDRESS: STREET 1: 968 JAMES STREET CITY: SYRACUSE STATE: NY ZIP: 13203 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CARROLS RESTAURANT GROUP, INC. CENTRAL INDEX KEY: 0000809248 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 161287774 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 968 JAMES STREET CITY: SYRACUSE STATE: NY ZIP: 13203 BUSINESS PHONE: 315-424-0513 MAIL ADDRESS: STREET 1: 968 JAMES STREET CITY: SYRACUSE STATE: NY ZIP: 13203 FORMER COMPANY: FORMER CONFORMED NAME: CARROLS HOLDINGS CORP DATE OF NAME CHANGE: 19870113 4 1 wf-form4_163355338219272.xml FORM 4 X0306 4 2021-10-05 0 0000809248 CARROLS RESTAURANT GROUP, INC. TAST 0001574550 DiGenova Gerald J C/O CARROLS RESTAURANT GROUP, INC. 968 JAMES STREET SYRACUSE NY 13203 0 1 0 0 VP, Human Resources Common Stock, $0.01 par value 2021-10-05 4 A 0 726 0 A 202344 D Represents restricted stock units issued to the Reporting Person under the Issuer's 2016 Stock Incentive Plan, as amended, as dividend equivalents in connection with a special cash dividend in the amount of $0.41 per share paid by the issuer on October 5, 2021. The restricted stock units will be subject to the same terms and conditions, including, without limitation, vesting, as the underlying restricted stock units previously issued to the Reporting Person. /s/ Gerald J. DiGenova 2021-10-06