4 1 option97form4.htm FORM 4 OPTION EXERCISE

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(h) of the Investment Company Act of 1940

Expires: January 31, 2005

Estimated average burden
hours per response 0.5

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

    2. Stark Richard J.
  • Issuer Name and Ticker or Trading Symbol

    • Good Times Restaurants Inc. (GTIM)

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

     

    x

    Director

    		  

    10% Owner

    (Last) (First) (Middle)
  • I.R.S. Identification Number of Reporting Person, if an entity (Voluntary)
    		•
  • Statement for Month/Day/Year

    • September 11, 2002

     

    		  

    Officer (give title below)

    		  

    Other (specify below)

    601 Corporate Circle

     

     

     

     

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

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

    Golden Colorado 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)

    2A. Deemed Execution Date, if any (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 Following Reported Transaction(s)

    (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

    Common Stock

    9/11/02

    		  

    M

    		  

    2000

    A

    $2.50

    7,100

    D

    		  

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    1. Title of Derivative Security (Instr. 3)

    2. Conversion or Exercise Price of Derivative Security

    3. Transaction Date (Month/ Day/Year)

    3A. Deemed Execution Date, if any (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 Following Reported Transaction(s) (Instr. 4)

    10. Ownership Form of Derivative Securities: 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

    Non Statutory Stock Option (right to buy)

    $2.50

    		  

     

    x

    		  

    2000

    		  

    10/01/97

    10/01/2002

    Common Stock

    2000

    		  

     

    14,000

     

    D

         		 

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Explanation of Responses:

    Exercise and hold

    Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

    /s/ Richard J. Stark

    September 11, 2002

    * If the form is filed by more than one reporting person, see Instruction 4(b)(v).

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

    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.

    **Signature of Reporting Person

    Date