0001209191-18-018778.txt : 20180312 0001209191-18-018778.hdr.sgml : 20180312 20180312145124 ACCESSION NUMBER: 0001209191-18-018778 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180309 FILED AS OF DATE: 20180312 DATE AS OF CHANGE: 20180312 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CRIVELLO JEFFERY CENTRAL INDEX KEY: 0001715474 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21625 FILM NUMBER: 18683092 MAIL ADDRESS: STREET 1: 12701 WHITEWATER DRIVE, SUITE 200 CITY: MINNETONKA STATE: MN ZIP: 55343 FORMER NAME: FORMER CONFORMED NAME: CRIVELLO JEFFREY DATE OF NAME CHANGE: 20170824 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FAMOUS DAVES OF AMERICA INC CENTRAL INDEX KEY: 0001021270 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 411782300 STATE OF INCORPORATION: MN FISCAL YEAR END: 1229 BUSINESS ADDRESS: STREET 1: 12701 WHITEWATER DRIVE STREET 2: SUITE 200 CITY: MINNETONKA STATE: MN ZIP: 55343 BUSINESS PHONE: 952-294-1300 MAIL ADDRESS: STREET 1: 12701 WHITEWATER DRIVE STREET 2: SUITE 200 CITY: MINNETONKA STATE: MN ZIP: 55343 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2018-03-09 0 0001021270 FAMOUS DAVES OF AMERICA INC DAVE 0001715474 CRIVELLO JEFFERY 12701 WHITEWATER DRIVE, SUITE 200 MINNETONKA MN 55343 1 1 0 0 Chief Executive Officer Common Stock 2018-03-09 4 M 0 11250 3.90 A 26250 D Stock Option (Right to Buy) 3.90 2018-03-09 4 M 0 11250 0.00 D 2027-11-14 Common Stock 11250 78750 D The option, representing a right to purchase a total of 90,000 shares, became exercisable in 24 equal installments beginning on December 14, 2017, /s/ Jeffery Crivello 2018-03-12