0001437749-17-013500.txt : 20170801 0001437749-17-013500.hdr.sgml : 20170801 20170801181758 ACCESSION NUMBER: 0001437749-17-013500 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170728 FILED AS OF DATE: 20170801 DATE AS OF CHANGE: 20170801 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: 17997858 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: 1225 BUSINESS ADDRESS: STREET 1: 27680 FRANKLIN ROAD CITY: SOUTHFIELD STATE: MI ZIP: 48034 BUSINESS PHONE: (248) 223-9160 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 rdgdoc.xml FORM 4 X0306 4 2017-07-28 0001394156 Diversified Restaurant Holdings, Inc. SAUC 0001435209 Dusenberry Jay Alan 27680 FRANKLIN ROAD SOUTHFIELD MI 48034 1 Common Stock 2017-07-28 4 A 0 14222 0 A 73344 D Common Stock 2015-07-16 4 F 0 1012 4.39 D 72332 D Common Stock 2016-05-23 4 F 0 1188 1.57 D 71144 D This transaction reports the disposition of shares to the issuer as a tax withholding in connection with vesting of restricted stock. It is being reported late due to an administrative oversight. /s/ Bradley J. Wyatt, Attorney-in-Fact 2017-08-01