0000029332-21-000021.txt : 20210312 0000029332-21-000021.hdr.sgml : 20210312 20210312153008 ACCESSION NUMBER: 0000029332-21-000021 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210310 FILED AS OF DATE: 20210312 DATE AS OF CHANGE: 20210312 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DAVIS W DEREK CENTRAL INDEX KEY: 0001196587 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-02585 FILM NUMBER: 21737135 MAIL ADDRESS: STREET 1: PO BOX 2007 CITY: DALTON STATE: GA ZIP: 30722 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DIXIE GROUP INC CENTRAL INDEX KEY: 0000029332 STANDARD INDUSTRIAL CLASSIFICATION: CARPETS AND RUGS [2273] IRS NUMBER: 620183370 STATE OF INCORPORATION: TN FISCAL YEAR END: 1226 BUSINESS ADDRESS: STREET 1: PO BOX 2007 CITY: DALTON STATE: GA ZIP: 30722 BUSINESS PHONE: 7068765814 MAIL ADDRESS: STREET 1: PO BOX 2007 CITY: DALTON STATE: GA ZIP: 30722 FORMER COMPANY: FORMER CONFORMED NAME: DIXIE YARNS INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: DIXIE MERCERIZING CO DATE OF NAME CHANGE: 19670524 4 1 wf-form4_161558098760106.xml FORM 4 X0306 4 2021-03-10 0 0000029332 DIXIE GROUP INC DXYN 0001196587 DAVIS W DEREK PO BOX 2007 DALTON GA 30722 0 1 0 0 VP HR/ Corporate Secretary Common Stock, $3 par value 2021-03-10 4 A 0 9200 0 A 110133 D Common Stock, $3 par value 2021-03-10 4 A 0 24553 0 A 134686 D Common Stock, $3 par value 2021-03-12 4 F 0 2824 3.27 D 131862 D Represents an award of restricted stock consisting of 9,200 Career Shares. Represents an award of restricted stock consisting of 24,553 Primary Long Term Incentive Plan Shares. Represents shares surrendered to Company to satisfy income tax withholding requirements with respect to vesting of an outstanding award of restricted stock. /s/ John F. Henry, Jr., by power of attorney for W. Derek Davis 2021-03-12