-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, JT3X7l+UJ3UpqwKTJu6MELntyRF69ejx+gR+DTLmdAr0l+ebq/sybR5cofItugNf Q9JEaGNnxl5LW5wkofYIpg== 0001179110-04-010816.txt : 20040518 0001179110-04-010816.hdr.sgml : 20040518 20040518163042 ACCESSION NUMBER: 0001179110-04-010816 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040514 FILED AS OF DATE: 20040518 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DAHLBERG K JEFFREY CENTRAL INDEX KEY: 0000938452 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21625 FILM NUMBER: 04816461 BUSINESS ADDRESS: STREET 1: 4200 DAHLBERG DRIVE CITY: MINNEAPOLIS STATE: MN ZIP: 55422 MAIL ADDRESS: STREET 1: GROW BIZ INTERNATIONAL INC STREET 2: 4200 DAHLBERG DRIVE CITY: MINNEAPOLIS STATE: MN ZIP: 55422-4837 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FAMOUS DAVES OF AMERICA INC CENTRAL INDEX KEY: 0001021270 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 411782300 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 8091 WALLACE ROAD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 BUSINESS PHONE: 952-294-1300 MAIL ADDRESS: STREET 1: 8091 WALLACE ROAD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 4 1 edgar.xml FORM 4 - X0202 4 2004-05-14 0 0001021270 FAMOUS DAVES OF AMERICA INC DAVE 0000938452 DAHLBERG K JEFFREY 1040 HIGH LAKE VIEW COLORADO SPRINGS CO 80906 1 0 0 0 Common Stock, $.01 par value 272800 D Director Stock Option 4 2004-02-28 2011-02-28 Common Stock, $.01 par value 50000 50000 D Director Stock Option 8.07 2003-05-23 2012-05-23 Common Stock, $.01 par value 5000 5000 D Director Stock Option 4.16 2004-06-13 2013-06-13 Common Stock, $.01 par valuve 5000 5000 D Director Stock Option 6.72 2004-05-14 4 A 0 5000 0 A 2005-05-14 2014-05-14 Common Stock, $.01 par value 5000 5000 D Pursuant to Rule 16b-3 (right to buy) s/ K Jeffrey Dahlberg 2004-05-18 -----END PRIVACY-ENHANCED MESSAGE-----