0001195734-24-000076.txt : 20240502 0001195734-24-000076.hdr.sgml : 20240502 20240502195505 ACCESSION NUMBER: 0001195734-24-000076 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240430 FILED AS OF DATE: 20240502 DATE AS OF CHANGE: 20240502 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dixon Adiya CENTRAL INDEX KEY: 0001838731 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36104 FILM NUMBER: 24910369 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] ORGANIZATION NAME: 07 Trade & Services 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 wk-form4_1714694095.xml FORM 4 X0508 4 2024-04-30 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 2024-04-30 4 M 0 50420 0 A 111873 D Common Stock 2024-04-30 4 F 0 14041 10.63 D 97832 D Performance Stock Units 2024-04-30 4 M 0 25210 0 D Common Stock 25210 0 D Shares withheld for payment of tax liability upon vesting of the performance stock units granted on April 26, 2021. Each performance stock unit represents a contingent right to receive one share of the Issuer's common stock. The performance stock units vest based on performance versus certain metrics as described in the award agreement. The performance stock units vested at 200% of the target award amount and were settled in shares of the Issuer's common stock pursuant to the terms of the award agreement. /s/ Adiya Dixon 2024-05-02