0001213900-23-019644.txt : 20230313 0001213900-23-019644.hdr.sgml : 20230313 20230313173753 ACCESSION NUMBER: 0001213900-23-019644 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230309 FILED AS OF DATE: 20230313 DATE AS OF CHANGE: 20230313 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Montgomery Dirk A CENTRAL INDEX KEY: 0001341991 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35373 FILM NUMBER: 23728384 MAIL ADDRESS: STREET 1: C/O HEALTH INSURANCE INNOVATIONS, INC. STREET 2: 15438 N. FLORIDA AVE., SUITE 201 CITY: TAMPA STATE: FL ZIP: 33613 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Fiesta Restaurant Group, Inc. CENTRAL INDEX KEY: 0001534992 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 900712224 STATE OF INCORPORATION: DE FISCAL YEAR END: 1229 BUSINESS ADDRESS: STREET 1: 14800 LANDMARK BOULEVARD, SUITE 500 CITY: DALLAS STATE: TX ZIP: 75254 BUSINESS PHONE: 972-702-9300 MAIL ADDRESS: STREET 1: 14800 LANDMARK BOULEVARD, SUITE 500 CITY: DALLAS STATE: TX ZIP: 75254 4 1 ownership.xml OWNERSHIP DOCUMENT X0306 4 2023-03-09 0 0001534992 Fiesta Restaurant Group, Inc. FRGI 0001341991 Montgomery Dirk A C/O FIESTA RESTAURANT GROUP, INC. 14800 LANDMARK BOULEVARD, SUITE 500 DALLAS TX 75254 0 1 0 0 Interim CEO and Treasurer Common Stock, par value $0.01 per share 2023-03-09 4 A 0 36586 0 A 217581 D The Shares were granted to the Reporting Person under the Issuer's 2021 Stock Incentive Plan. /s/ Dirk Montgomery 2023-03-13