-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, WOc30Aan+KGrirelBIyZGjs+5rbNJo1L+hhx+SAmsuT80rvCM0Gp+fa0XGermahz F7jRvBXQmG2/KSEiHZ7EHA== 0000879554-03-000002.txt : 20030106 0000879554-03-000002.hdr.sgml : 20030106 20030106160314 ACCESSION NUMBER: 0000879554-03-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021231 FILED AS OF DATE: 20030106 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CHECKERS DRIVE IN RESTAURANTS INC /DE CENTRAL INDEX KEY: 0000879554 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 581654960 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19649 FILM NUMBER: 03505152 BUSINESS ADDRESS: STREET 1: 4300 WEST CYPRESS STREET STREET 2: SUITE 600 CITY: TAMPA STATE: FL ZIP: 33607 BUSINESS PHONE: 8132837000 MAIL ADDRESS: STREET 1: 4300 WEST CYPRESS STREET STREET 2: SUITE 600 CITY: TAMPA STATE: FL ZIP: 33607 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: DAVIS WILLIE D CENTRAL INDEX KEY: 0001053288 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: BASSETT FURNITURE INDUSTRIES INC STREET 2: P O BOX 626 CITY: BASSETT STATE: VA ZIP: 24055 BUSINESS PHONE: 5406296209 MAIL ADDRESS: STREET 1: BASSETT FURNITURE INDUSTRIES INC STREET 2: P O BOX 626 CITY: BASSETT STATE: VA ZIP: 24055 4 1 davisform4123102.txt UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). 1. Name and Address of Reporting Person DAVIS, WILLIE D. 161 NORTH LA BREA INGLEWOOD, CA 90301 U.S.A. 2. Issuer Name and Ticker or Trading Symbol CHECKERS DRIVE-IN RESTAURANTS, INC. (CHKR) 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Day/Year DECEMBER 31, 2002 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( X ) Director ( ) 10% Owner ( ) Officer (Give Title Below) ( ) Other (Specify Below) 7. Individual or Joint/Group Filing (Check Applicable) (X ) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CHECKERS DRIVE-IN RESTAURANTS, INC. CENTRAL INDEX KEY: 0000879554 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 581654960 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 SEC FILE NUMBER: 000-19649 BUSINESS/MAILING ADDRESS: STREET 1: 4300 WEST CYPRESS STREET, SUITE 600 CITY: TAMPA STATE: FL ZIP: 33607 BUSINESS PHONE: 8132837000 Table I Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned Title of Non-Derivative Security Transaction Date Transaction Code Security Amount Securities Acquired/ Disposed (A/D) Securities Price Amount Beneficially Owned at End of the Month Ownership Direct or Indirect Nature of Indirect Beneficial Ownership Table II Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) Title of Derivative Security Conversion or Exercise Price Transaction Date Transaction Code Securities Acquired/ Disposed Date Exercisable Expiration Date Title Number of Shares Price of Security Number Beneficially Owned End of Month Ownership Direct or Indirect Nature of Indirect Beneficial Ownership Common Stock (Right to Buy) $6.26 12/31/02 A A 12/31/02 12/31/12 C 1,667 1,667 D Explanation of Responses: ______________________________________________ ______________ Signature of Reporting Person Date -----END PRIVACY-ENHANCED MESSAGE-----