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 |
|
|||||||||||||||
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*
(Street)
|
2. Issuer Name and Ticker or Trading Symbol
Good Times Restaurants Inc. [ GTIM ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
||||||||||||||||||||||||
3. Date of Earliest Transaction
(Month/Day/Year) 06/28/2021 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
|
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 | 06/28/2021 | M(1) | 1,615 | A | $0.00 | 49,714 | 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 | 11/16/2020(2) | 11/16/2021 | Common Stock | 914 | 914 | D | ||||||||
Non-Qualified Stock Options | $1.31 | 12/14/2011(3) | 12/14/2021 | Common Stock | 5,000 | 5,914 | D | ||||||||
Non-Qualified Stock Options | $2.31 | 01/02/2013(4) | 01/02/2023 | Common Stock | 2,000 | 7,914 | D | ||||||||
Non-Qualified Stock Options | $2.44 | 09/27/2013(5) | 09/27/2023 | Common Stock | 5,000 | 12,914 | D | ||||||||
Non-Qualified Stock Options | $5.29 | 11/23/2015(6) | 11/23/2025 | Common Stock | 3,781 | 16,695 | D | ||||||||
Non-Qualified Stock Options | $4.25 | 07/23/2018(7) | 07/23/2028 | Common Stock | 2,715 | 19,410 | D |
Explanation of Responses: |
1. Represents the conversion upon vesting of Restricted Stock Units into Common Stock. The reporting person was granted 9,412 Restricted Stock Units 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. |
2. The Reporting Person was granted 2,740 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 |
3. The Reporting Person was granted 5,000 Non-Qualified Stock Options (Right to Buy) on December 14, 2011 vesting at 1/5 of the total amount granted over five years. |
4. The Reporting Person was granted 2,000 Non-Qualified Stock Options (Right to Buy) on January 1, 2013 vesting at 1/5 of the total amount granted over five years. |
5. The Reporting Person was granted 5,000 Non-Qualified Stock Options (Right to Buy) on September 27, 2013 vesting at 1/5 of the total amount granted over five years. |
6. The Reporting Person was granted 3,781 Non-Qualified Stock Options (Right to Buy) on November 23, 2015 vesting at 1/5 of the total amount granted over five years. |
7. The Reporting Person was granted 2,715 Non-Qualified Stock Options (Right to Buy) on July 23, 2018 vesting at 1/5 of the total amount granted over five years. |
Remarks: |
Geoffrey R. Bailey | 06/28/2021 | |
** 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. |