0001195734-16-000100.txt : 20160705 0001195734-16-000100.hdr.sgml : 20160705 20160705130841 ACCESSION NUMBER: 0001195734-16-000100 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160701 FILED AS OF DATE: 20160705 DATE AS OF CHANGE: 20160705 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: 1231 BUSINESS ADDRESS: STREET 1: 111 N. CANAL STREET 2: SUITE 850 CITY: CHICAGO STATE: IL ZIP: 60606 BUSINESS PHONE: 3129510600 MAIL ADDRESS: STREET 1: 111 N. CANAL STREET 2: SUITE 850 CITY: CHICAGO STATE: IL ZIP: 60606 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: REVORD MATTHEW J CENTRAL INDEX KEY: 0001587682 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36104 FILM NUMBER: 161749633 MAIL ADDRESS: STREET 1: C/O POTBELLY CORPORATION STREET 2: 111 NORTH CANAL, SUITE 850 CITY: CHICAGO STATE: IL ZIP: 60606 4 1 edgardoc.xml PRIMARY DOCUMENT X0306 4 2016-07-01 0 0001195734 POTBELLY CORP PBPB 0001587682 REVORD MATTHEW J 111 N. CANAL SUITE 850 CHICAGO IL 60606 0 1 0 0 SVP, GC and Secretary Common Stock 2016-07-01 4 M 0 30000.0 8.0 A 30000 D Common Stock 2016-07-01 4 S 0 30000.0 12.4641 D 0 D Common Stock 13775 I by Trust Non-Qualified Stock Option (right to buy) 8.0 2016-07-01 4 M 0 30000.0 0.0 D 2017-01-08 Common Stock 30000 70000 D These shares were sold in compliance with a trading plan adopted by the reporting person pursuant to Rule 10b5-1 under the Securities Exchange Act of 1934, as amended. The stock options vested and became exercisable prior to Potbelly Corporation's initial public offering. By: Robyn Martin For: Matthew Revord 2016-07-05