-----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, Mfh8J8l13L4fSrhRtss0MLDe5YdDFvBer08+Uy/NaYLYlFKB2aQuCsYDU9MAc0MJ fgOp3mimJQx3TNRRCwFncg== 0000950124-97-000677.txt : 19970222 0000950124-97-000677.hdr.sgml : 19970222 ACCESSION NUMBER: 0000950124-97-000677 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970212 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FAMOUS DAVE S OF AMERICA INC CENTRAL INDEX KEY: 0001021270 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 411782300 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-47211 FILM NUMBER: 97525861 BUSINESS ADDRESS: STREET 1: 12700 INDUSTRIAL PARK BLVD CITY: PLYMOUTH STATE: MN ZIP: 55441 BUSINESS PHONE: 612-557-57 MAIL ADDRESS: STREET 1: 12700 INDUSTRIAL PARK BLVD CITY: PLYMOUTH STATE: MN ZIP: 55441 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: ANDERSON DAVID W CENTRAL INDEX KEY: 0000902654 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 12700 INDUSTRIAL PARK BLVD CITY: MINNEAPOLIS STATE: MN ZIP: 55441 BUSINESS PHONE: 6125575798 MAIL ADDRESS: STREET 1: 12700 INDUSTRIAL PARK BLVD CITY: MINNEAPOLIS STATE: MN ZIP: 55441 SC 13G 1 FAMOUS DAVE'S OF AMERICA, INC. 1 SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ______________________ SCHEDULE 13G Under the Securities Exchange Act of 1934 FAMOUS DAVE'S OF AMERICA, INC. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock, $.01 par value - -------------------------------------------------------------------------------- (Title of Class of Securities) 307068 10 6 - -------------------------------------------------------------------------------- (CUSIP Number) _______ (Continued on following page(s)) Page 1 of 4 Pages 2 13G(Individuals - continued) Page 2 of 4 - ------------------------ CUSIP No. 307068 10 6 - ------------------------ 1. Name of Reporting Person and I.R.S. Identification No.: DAVID W. ANDERSON & KATHRYN W. ANDERSON ####-##-#### 2. Member of a Group: (a) ________ (b) 3. SEC USE ONLY: 4. Citizenship or Place of Organization: U.S.A. 5. Sole Voting Power: -0- 6. Shared Voting Power: 1,781,000 7. Sole Dispositive Power: -0- 8. Shared Dispositive Power: 1,781,000 9. Aggregate Amount Beneficially Owned by each Reporting Person: 1,781,000 10. Check Box if the Aggregate Amount in Row 9 excludes Certain Shares: _______ 11. Percent of Class Represented by Amount in Row 9: 29.6% 12. Type of Reporting Person: IN 3 13G(Individuals - continued) Page 3 of 4 Item 1(a) and (b) NAME AND ADDRESS OF ISSUER: Famous Dave's of America, Inc. 12700 Industrial Park Boulevard Minneapolis, MN 55441 Item 2(a) NAME OF PERSON FILING: David W. Anderson & Kathryn W. Anderson Item 2(b) ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE: 12700 Industrial Park Boulevard Minneapolis, MN 55441 Item 2(c) CITIZENSHIP: U.S.A. Item 2(d) TITLE OF CLASS OF SECURITIES: Common Stock, $.01 par value Item 2(e) CUSIP NUMBER: 307068 10 6 Item 3 THIS STATEMENT IS NOT FILED PURSUANT TO RULES 13d-1(b) OR 13d-2(b). Item 4(a) AMOUNT BENEFICIALLY OWNED: 1,781,000 shares at December 31, 1996. --------- Item 4(b) PERCENT OF CLASS: 29.6% percent pursuant to Rule 13d-3(c). Item 4(c) NUMBER OF SHARES AS TO WHICH SUCH PERSON HAS (1) Sole power to vote or to direct the vote -0- (2) Shared power to vote or to direct the vote 1,781,000 (3) Sole power to dispose or to direct the disposition of -0- (4) Shared power to dispose or to direct the disposition of 1,781,000 Item 5 OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS. Not Applicable Item 6 OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON. Not Applicable Item 7 IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY. Not Applicable 4 13G (Individuals - continued) Page 4 of 4 Item 8 IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP. Not Applicable Item 9 NOTICE OF DISSOLUTION OF GROUP. Not Applicable Item 10 CERTIFICATION. Not Applicable SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Date February 6, 1997. s/ David W. Anderson --------------------- David W. Anderson s/ Kathryn W. Anderson --------------------- Kathryn W. Anderson -----END PRIVACY-ENHANCED MESSAGE-----