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POTBELLY CORP — Director's Dealing 2013
Oct 3, 2013
32799_dirs_2013-10-03_dc0bda00-feba-422f-a105-2f1535ed0f85.zip
Director's Dealing
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SEC Form 3 — Initial Statement of Beneficial Ownership
Issuer: POTBELLY CORP (PBPB)
CIK: 0001195734
Period of Report: 2013-10-03
Reporting Person: OXFORD BLACKPOINT VENTURE PARTNERS VII, LLC (10% Owner)
Reporting Person: OXFORD CAPITAL PARTNERS, INC. (10% Owner)
Holdings (Non-Derivative)
| Security | Shares | Ownership |
|---|---|---|
| Common Stock | 163525 | Direct |
Holdings (Derivative)
| Security | Exercise Price | Expiration | Underlying | Shares | Ownership |
|---|---|---|---|---|---|
| Series A Preferred Stock | $ | Common Stock (500000) | Direct | ||
| Series B Preferred Stock | $ | Common Stock (142892) | Direct | ||
| Series C Preferred Stock | $ | Common Stock (109270) | Direct | ||
| Series D Preferred Stock | $ | Common Stock (136239) | Direct | ||
| Series E Preferred Stock | $ | Common Stock (266096) | Direct | ||
| Series F Preferred Stock | $ | Common Stock (82927) | Direct | ||
| Common Stock Warrants | $8.16 | Common Stock (241704) | Indirect |
Footnotes
F1: The Series A Preferred Stock is convertible into Potbelly Corporation ("Potbelly") common stock on a 1-to-1 basis at the option of the holder and has no expiration date. The Series A Preferred Stock will automatically convert into common stock on a 1-to-1 basis upon the closing of Potbelly's initial public offering.
F2: The Series B Preferred Stock is convertible into Potbelly common stock on a 1-to-1 basis at the option of the holder and has no expiration date. The Series B Preferred Stock will automatically convert into common stock on a 1-to-1 basis upon the closing of Potbelly's initial public offering.
F3: The Series C Preferred Stock is convertible into Potbelly common stock on a 1-to-1.0086 basis at the option of the holder and has no expiration date. The Series C Preferred Stock will automatically convert into common stock on a 1-to-1.0086 basis upon the closing of Potbelly's initial public offering.
F4: The Series D Preferred Stock is convertible into Potbelly common stock on a 1-to-1.0268 basis at the option of the holder and has no expiration date. The Series D Preferred Stock will automatically convert into common stock on a 1-to-1.0268 basis upon the closing of Potbelly's initial public offering.
F5: The Series E Preferred Stock is convertible into Potbelly common stock on a 1-to-1.0348 basis at the option of the holder and has no expiration date. The Series E Preferred Stock will automatically convert into common stock on a 1-to-1.0348 basis upon the closing of Potbelly's initial public offering.
F6: The Series F Preferred Stock is convertible into Potbelly common stock on a 1-to-1 basis at the option of the holder and has no expiration date. The Series F Preferred Stock will automatically convert into common stock on a 1-to-1 basis upon the closing of Potbelly's initial public offering.
F7: Oxford Capital Partners, Inc. ("Oxford Capital") may exercise the warrant at any time prior to the earliest to occur of (i) the fifth anniversary of the closing of Potbelly's initial public offering or (ii) a Liquidity Event (which term generally includes a sale of all or substantially all of Potbelly's assets or a transfer of the voting power to elect a majority of its board of directors through a sale of capital stock or the consummation of a merger or consolidation).
F8: Oxford Blackpoint Venture Partners VII, LLC ("Oxford Blackpoint") is an investment fund managed by Oxford Capital. Vann Avedisian is co-owner of Oxford Capital. Accordingly, Mr. Avedisian may be deemed to share power to vote and dispose of the securities owned directly by Oxford Blackpoint and Oxford Capital. Mr. Avedisian disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein.