0000899243-21-020484.txt : 20210524 0000899243-21-020484.hdr.sgml : 20210524 20210524211511 ACCESSION NUMBER: 0000899243-21-020484 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210520 FILED AS OF DATE: 20210524 DATE AS OF CHANGE: 20210524 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Near David CENTRAL INDEX KEY: 0001360894 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36104 FILM NUMBER: 21957113 MAIL ADDRESS: STREET 1: 111 N CANAL ST STREET 2: SUITE 850 CITY: CHICAGO STATE: IL ZIP: 60601 FORMER NAME: FORMER CONFORMED NAME: Near David J DATE OF NAME CHANGE: 20060427 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: POTBELLY CORP CENTRAL INDEX KEY: 0001195734 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 364466837 FISCAL YEAR END: 1230 BUSINESS ADDRESS: STREET 1: 111 N. CANAL STREET 2: SUITE 325 CITY: CHICAGO STATE: IL ZIP: 60606 BUSINESS PHONE: 3129510600 MAIL ADDRESS: STREET 1: 111 N. CANAL STREET 2: SUITE 325 CITY: CHICAGO STATE: IL ZIP: 60606 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-05-20 0 0001195734 POTBELLY CORP PBPB 0001360894 Near David 111 N. CANAL, SUITE 325 CHICAGO IL 60606 1 0 0 0 Common Stock 2021-05-20 4 A 0 19852 0.00 A 67721 D Represents an award of restricted stock units. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock. These restricted stock units vest on May 20, 2022. /s/ David Near 2021-05-24