0001181431-12-042396.txt : 20120727
0001181431-12-042396.hdr.sgml : 20120727
20120727103439
ACCESSION NUMBER: 0001181431-12-042396
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120727
FILED AS OF DATE: 20120727
DATE AS OF CHANGE: 20120727
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Young Michael Roger
CENTRAL INDEX KEY: 0001553519
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35603
FILM NUMBER: 12989193
MAIL ADDRESS:
STREET 1: 1623 TOOMEY ROAD
CITY: AUSTIN
STATE: TX
ZIP: 78704
FORMER NAME:
FORMER CONFORMED NAME: Young Michael R.
DATE OF NAME CHANGE: 20120703
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CHUY'S HOLDINGS, INC.
CENTRAL INDEX KEY: 0001524931
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812]
IRS NUMBER: 205717694
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1623 TOOMEY ROAD
CITY: AUSTIN
STATE: TX
ZIP: 78704
BUSINESS PHONE: 512-473-2783
MAIL ADDRESS:
STREET 1: 1623 TOOMEY ROAD
CITY: AUSTIN
STATE: TX
ZIP: 78704
4
1
rrd351686.xml
FORM 4
X0306
4
2012-07-27
0
0001524931
CHUY'S HOLDINGS, INC.
CHUY
0001553519
Young Michael Roger
1623 TOOMEY ROAD
AUSTIN
TX
78704
1
0
1
1
Member of 10% Owner Group
Common Stock
2012-07-27
4
C
0
834934
0
A
834934
I
See footnote
Common Stock
2012-07-27
4
C
0
60604
0
A
895538
I
See footnote
Series B Preferred Stock
2012-07-27
4
C
0
834934
0
D
Common Stock
834934
0
I
See footnote
Series X Preferred Stock
2012-07-27
4
C
0
60604
0
D
Common Stock
60604
0
I
See footnote
Represents shares beneficially owned by MY/ZP Equity, LP ("MY/ZP Equity"), an entity in which Mr. Young is a limited partner. MY/ZP GP, LLC ("MY/ZP GP") is the sole general partner of MY/ZP Equity. Mr. Young, as trustee of the Young Descendants' Trust, is a member of MY/ZP GP and has voting and dispositive power of the shares and may be deemed to indirectly beneficially own the shares. Mr. Young disclaims beneficial ownership of the shares held by MY/ZP Equity.
The series B preferred stock converted into common stock of Chuy's Holdings, Inc. (the "Company") on a one-for-one basis immediately prior to the closing of the Company's initial public offering. The series B preferred stock had no expiration date.
The series X preferred stock converted into common stock of the Company on a one-for-one basis immediately prior to the closing of the Company's initial public offering. The series X preferred stock had no expiration date.
/s/ Sharon Russell, attorney-in-fact
2012-07-27