0000809248-24-000014.txt : 20240117 0000809248-24-000014.hdr.sgml : 20240117 20240117172844 ACCESSION NUMBER: 0000809248-24-000014 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240115 FILED AS OF DATE: 20240117 DATE AS OF CHANGE: 20240117 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DERBY DEBORAH CENTRAL INDEX KEY: 0001232303 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33174 FILM NUMBER: 24539429 MAIL ADDRESS: STREET 1: TOYS R US INC STREET 2: 225 SUMMIT AVE CITY: MONTVALE STATE: NJ ZIP: 07645 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CARROLS RESTAURANT GROUP, INC. CENTRAL INDEX KEY: 0000809248 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] ORGANIZATION NAME: 07 Trade & Services 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 wk-form4_1705530513.xml FORM 4 X0508 4 2024-01-15 0 0000809248 CARROLS RESTAURANT GROUP, INC. TAST 0001232303 DERBY DEBORAH C/O CARROLS RESTAURANT GROUP, INC. 968 JAMES STREET SYRACUSE NY 13203 1 1 0 0 President and CEO 0 Common Stock, $0.01 par value 2024-01-15 4 A 0 122400 0 A 672968 D The shares were granted to the Reporting Person pursuant to the Issuer's 2016 Stock Incentive Plan, as amended and restated. /s/ Deborah M. Derby 2024-01-17