0001209191-19-015310.txt : 20190304 0001209191-19-015310.hdr.sgml : 20190304 20190304095503 ACCESSION NUMBER: 0001209191-19-015310 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190228 FILED AS OF DATE: 20190304 DATE AS OF CHANGE: 20190304 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: 19652198 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: 1230 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 2019-02-28 0 0001021270 FAMOUS DAVES OF AMERICA INC DAVE 0001715474 CRIVELLO JEFFERY 12701 WHITEWATER DRIVE, SUITE 190 MINNETONKA MN 55343 1 1 0 0 Chief Executive Officer Common Stock 2019-02-28 4 A 0 180000 0.00 A 221848 D Restricted stock that vests in equal monthly installments over 48 months. /s/ Jeffery Crivello 2019-03-04