0001394156-19-000035.txt : 20190529 0001394156-19-000035.hdr.sgml : 20190529 20190529104211 ACCESSION NUMBER: 0001394156-19-000035 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190524 FILED AS OF DATE: 20190529 DATE AS OF CHANGE: 20190529 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dusenberry Jay Alan CENTRAL INDEX KEY: 0001435209 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35881 FILM NUMBER: 19860255 MAIL ADDRESS: STREET 1: 7236 AUDUBON CITY: CLAY TOWNSHIP STATE: MI ZIP: 48307 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Diversified Restaurant Holdings, Inc. CENTRAL INDEX KEY: 0001394156 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 030606420 STATE OF INCORPORATION: NV FISCAL YEAR END: 1230 BUSINESS ADDRESS: STREET 1: 27680 FRANKLIN ROAD CITY: SOUTHFIELD STATE: MI ZIP: 48034 BUSINESS PHONE: (833) 374-7282 MAIL ADDRESS: STREET 1: 27680 FRANKLIN ROAD CITY: SOUTHFIELD STATE: MI ZIP: 48034 FORMER COMPANY: FORMER CONFORMED NAME: Diversified Restaurants Holding, Inc. DATE OF NAME CHANGE: 20070322 4 1 wf-form4_155914091597270.xml FORM 4 X0306 4 2019-05-24 0 0001394156 Diversified Restaurant Holdings, Inc. SAUC 0001435209 Dusenberry Jay Alan 27680 FRANKLIN ROAD SOUTHFIELD MI 48034 1 0 0 0 Common Stock 2019-05-24 4 F 0 6897 0.88 D 91833 D This transaction reports the disposition of shares to the issuer as a tax withholding in connection with vesting of restricted stock. /s/ Stacy C. Spence, Attorney-in-Fact 2019-05-24