0001195734-23-000084.txt : 20230509 0001195734-23-000084.hdr.sgml : 20230509 20230509202837 ACCESSION NUMBER: 0001195734-23-000084 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230509 FILED AS OF DATE: 20230509 DATE AS OF CHANGE: 20230509 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dixon Adiya CENTRAL INDEX KEY: 0001838731 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36104 FILM NUMBER: 23903969 MAIL ADDRESS: STREET 1: 111 N CANAL STREET 2: SUITE 850 CITY: CHICAGO STATE: IL ZIP: 60606 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 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 wf-form4_168367849771584.xml FORM 4 X0407 4 2023-05-09 0 0001195734 POTBELLY CORP PBPB 0001838731 Dixon Adiya 111 N. CANAL SUITE 325 CHICAGO IL 60606 0 1 0 0 SVP, CLO and Secretary 0 Common Stock 2023-05-09 4 P 0 2421 8.24 A 67940 D /s/ Adiya Dixon 2023-05-09