SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
KNUTSON SUSAN M

(Last) (First) (Middle)
141 UNION BLVD., #400

(Street)
LAKEWOOD CO 80228

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Good Times Restaurants Inc. [ GTIM ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Controller, Corp Secretary
3. Date of Earliest Transaction (Month/Day/Year)
11/16/2019
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
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 11/18/2019 M(1) 2,063(1) A $0.00 22,542 D
Common Stock 11/18/2019 F(2) 707 D $1.74 21,835 D
Common Stock 11/18/2019 M(3) 1,934(3) A $0.00 23,769 D
Common Stock 11/18/2019 F(2) 663 D $1.74 23,106 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: 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
Restricted Stock Units $0.00 11/18/2019 M 2,063(1) 11/16/2019 11/16/2021 Common Stock 2,063 $0.00 0 D
Restricted Stock Units $0.00 11/18/2019 M 1,934(3) 11/16/2019 11/16/2021 Common Stock 1,934 $0.00 3,870 D
Restricted Stock Units $0.00 06/27/2018(4) 11/16/2021 Common Stock 3,645 7,515 D
Incentive Stock Options (Right to buy) $1.56 12/13/2010(5) 12/13/2020 Common Stock 5,323 5,323 D
Incentive Stock Options (Right to Buy) $2.31 01/02/2013(6) 01/02/2023 Common Stock 18,132 23,455 D
Incentive Stock Options (Right to buy) $2.48 11/21/2013(7) 11/21/2023 Common Stock 10,000 33,455 D
Incentive Stock Options $5.29 11/23/2015(8) 11/23/2025 Common Stock 4,159 37,614 D
Incentive Stock Options (Right to Buy) $3.15 11/16/2016(9) 11/16/2026 Common Stock 7,700 45,314 D
Incentive Stock Options (Right to buy) $3.55 06/27/2018(10) 06/27/2028 Common Stock 7,324 52,638 D
Incentive Stock Options (Right to buy) $4.25 07/23/2018(11) 07/23/2028 Common Stock 2,123 54,761 D
Incentive Stock Options (Right to buy) $4.66 11/16/2018(12) 11/16/2028 Common Stock 5,579 60,340 D
Explanation of Responses:
1. Represents the conversion upon vesting of Restricted Stock Units into Common Stock. The Reporting Person was granted 6,191 Restricted Stock Units on November 16, 2016 vesting at 1/3 of the total granted amount over three years. Such Restricted Stock Units were previously reported in Table II on a Form 4 filed with the Securities and Exchange Commission.
2. Represents shares withheld to cover the exercise price of the options exercised.
3. Represents the conversion upon vesting of Restricted Stock Units into Common Stock. The Reporting Person was granted 5,804 Restricted Stock Units on November 16, 2018 vesting at 1/3 of the total granted amount over three years. Such Restricted Stock Units were previously reported in Table II on a Form 4 filed with the Securities and Exchange Commission.
4. The Reporting Person was granted 5,467 Restricted Stock Units ("RSU") on June 27, 2018 vesting at 1/3 of the total granted amount over three years. Such Restricted Stock Units were previously reported in Table II on a Form 4 filed with the Securities and Exchange Commission.
5. The Reporting Person was granted 5,323 Incentive Stock Options (Right to Buy) on December 13, 2010 vesting at 1/5 of the total amount granted over five years.
6. The Reporting Person was granted 18,132 Incentive Stock Options (Right to Buy) on January 2, 2013 vesting at 1/5 of the total amount granted over five years.
7. The Reporting Person was granted 10,000 Incentive Stock Options (Right to Buy) on November 21, 2013 vesting at 1/5 of the total amount granted over five years.
8. The Reporting Person was granted 4,159 Incentive Stock Options (Right to Buy) on November 23, 2015 vesting at 1/5 of the total amount granted over five years.
9. The Reporting Person was granted 7,700 Incentive Stock Options (Right to Buy) on November 16, 2016 vesting at 1/5 of the total amount granted over five years.
10. The Reporting Person was granted 7,324 Incentive Stock Options (Right to Buy) on June 27, 2018 vesting at 1/5 of the total amount granted over five years.
11. The Reporting Person was granted 2,123 Incentive Stock Options (Right to Buy) on July 23, 2018 vesting at 1/5 of the total amount granted over five years.
12. The Reporting Person was granted 7,700 Incentive Stock Options (Right to Buy) on November 16, 2018 vesting at 1/5 of the total amount granted over five years.
Remarks:
Susan M. Knutson 11/20/2019
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.