-----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, Av61+1WRG48RiHWjqnnySwi+lUeACkTSLreGjrmPp5Qopjonb/gAZI/Lm6b5uw/k ko0lLXhW5EMdiV2bKdZqYw== 0000879554-03-000018.txt : 20030117 0000879554-03-000018.hdr.sgml : 20030117 20030117143544 ACCESSION NUMBER: 0000879554-03-000018 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030117 FILED AS OF DATE: 20030117 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: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19649 FILM NUMBER: 03517603 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: TURER RICHARD S CENTRAL INDEX KEY: 0001137755 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 5 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 5 1 turerform5011703.txt UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 5 ANNUAL 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 TURER, RICHARD S. 2983 EAGLES ESTATES CLEARWATER, FL 33761 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 17, 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 OF MARKETING 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 Period Ownership Form: Direct or Indirect Nature of Indirect Beneficial Ownership Code V Amount A/D Price Common Stock* 06/27/02 P V 125.2049 A $10.69 D 2,332.7030 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) Common Stock (Right to Buy)** $10.80 04/08/02 A 30,000 04/08/03 04/08/12 C 30,000 30,000 D Explanation of Responses: * = Employee Stock Purchase Plan (ESPP) Shares ** = Vesting in 1/3 increments beginning 4/8/03 ______________________________________________ ______________ Signature of Reporting Person Date -----END PRIVACY-ENHANCED MESSAGE-----