-----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, Id3r4foaABl8hMwhkGXvGdVgRBggMuSPSxJoyfJELQLjtOmq3ckzA87IwNuWqIgI 7/kW23dAcRXgwKyPW6bZ6w== 0000879554-03-000008.txt : 20030114 0000879554-03-000008.hdr.sgml : 20030114 20030110104755 ACCESSION NUMBER: 0000879554-03-000008 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030109 FILED AS OF DATE: 20030110 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: 03509952 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: KOEHLER DAVID G CENTRAL INDEX KEY: 0001171080 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 4300 W. CYPRESS STREET STREET 2: SUITE 600 CITY: TAMPA STATE: FL ZIP: 33607 BUSINESS PHONE: 8132837000 MAIL ADDRESS: STREET 1: 4300 W. CYPRESS STREET STREET 2: SUITE 600 CITY: TAMPA STATE: FL ZIP: 33607 4 1 koehlerform4010903.txt FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL WASHINGTON, D.C. 20549 OMB Number: 3235-0287 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Expires: January 31, 2005 Estimated average burden hours per response. . . . 05 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 ( ) 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 KOEHLER, DAVID G. 5006 DAVENSHIRE WAY TAMPA, FL 33647 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 JANUARY 9, 2003 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner ( X ) Officer (Give Title Below) ( ) Other (Specify Below) VICE PRESIDENT, CFO AND TREASURER 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 Securities Acquired (A) or Disposed (D) Amount Beneficially Owned at End of Month Ownership Form: Direct or Indirect Nature of Indirect Beneficial Ownership Code V Amount A/D Price Common Stock 01/09/03 P V 57.5920 A $6.61446 3,048.8461 D 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 Number of Securities Acquired or Disposed Date Exercisable Expiration Date Title of Securities Amount of Underlying Securities Price of Security Number Beneficially Owned End of Month Ownership Direct or Indirect Nature of Indirect Beneficial Ownership Code V (A) (D) Explanation of Responses: ______________________________________________ ______________ Signature of Reporting Person Date -----END PRIVACY-ENHANCED MESSAGE-----