4 1 btf4.htm ROBERT TURRILL FILING

F O R M 4

  

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

OMB Approval
   

OMB Number 3235-0287

Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility

Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940

Expires: December 31, 2001

Estimated average burden
hours per response 0.5

(Print or Type Responses)
  1. Name and Address of Reporting Person*

    2. Turrill Robert D.
  • Issuer Name and Ticker or Trading Symbol

    • Good Times Restaurants Inc. GTIM

    6. Relationship of Reporting Person(s) to Issuer
    (Check all applicable)
     

    Director

    10% Owner

    (Last) (First) (Middle)
  • I.R.S. Identification Number of Reporting Person, if an entity (Voluntary)

    		•
  • Statement for Month/Year

    • 10/01

    		  

    X

    Officer (give title below)

    Other (specify below)

    601 Corporate Circle

    		  

    Vice President of Marketing

    		  
     

    (Street
  • If Amendment, Date of Original (Month/Year)

    		•

    7. Individual or Joint/Group Filing
    (Check Applicable Line)

    Golden CO 80401
     

    X

    Form filed by One Reporting Person

    Form filed by More than One Reporting Person

    (City) (State) (Zip)

    Table I Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

    1. Title of Security
    (Instr. 3)

    2. Transaction Date (Month/ Day/Year)

    3. Transaction Code
    (Instr. 8)

    4. Securities Acquired (A) or
    Disposed of (D)
    (Instr. 3, 4 and 5)

    5. Amount of Securities Beneficially Owned at End of Month (Instr. 3 and 4)

    6. Ownership
    Form: Direct (D) or Indirect (I) (Instr. 4)

    7. Nature of Indirect Beneficial Ownership (Instr. 4)

    Code

    V

    Amount

    (A) or (D)

    Price

    1,888

                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       

    Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
    * If the form is filed by more than one reporting person, see Instruction 4(b)(v). SEC 1474 (3-99)

    1. Title of Derivative Security (Instr. 4)

    2. Conversion or Exercise Price of Derivative Security

    3. Transaction Date (Month/ Day/Year)

    4. Transaction Code (Instr. 8)

    5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)

    6. Date Exercisable and Expiration Date (Month/Day/Year)

    7. Title and Amount of Underlying Securities (Instr. 3 and 4)

    8. Price of Derivative Security (Instr. 5)

    9. Number of Derivative Securities Beneficially Owned at End of Month (Instr. 4)

    10.Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr.  4)

    11. Nature of Indirect Beneficial Ownership (Instr. 4)

    Code

    V

    (A)

    (D)

    Date Exercisable

    Expiration Date

    Title

    Amount or Number of Shares

    Employee Incentive Stock Option

    $1.75

    10/01/01

    A

    V

    8,000

    (1)

    10/01/11

    Employee Incentive Stock Options

    8,000

    $1.75

    69,321

    D

    Non-Statutory Stock Option (right to buy)

    $1.75

    10/01/01

    A

    V

    2,761

    		  

    10/01/01

    10/01/06

    Common Stock

    2,761

    $1.75

    72,082

    D

    		  
                                 
                                 
                                 
                                 
                                 
                                 
                                 
                                 
                                 
                                 

    Explanation of Responses:

    (1) The option vests 10% after the first year, an additional 20% after the second year, and additional 30% after the third year and becomes fully vested after the fourth year.

    ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations.

    /s/ Robert Turrill

    December 6, 2001

    See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a)

    Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

    Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.

    **Signature of Reporting Person

    Date