F O R M 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 |
OMB Approval |
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OMB Number 3235-0287 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 |
Expires: December 31, 2001 Estimated average burden |
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(Print or Type Responses) |
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Bailey David E. |
Good Times Restaurants Inc. (GTIM) |
6. Relationship of Reporting Person(s) to Issuer |
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X |
Director |
10% Owner |
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(Last) (First) (Middle) |
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October 2002 |
Officer (give title below) |
Other (specify below) |
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601 Corporate Circle |
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(Street |
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7. Individual or Joint/Group Filing |
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Golden Colorado 80401 |
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X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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(City) (State) (Zip) |
Table I Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security |
2. Transaction Date (Month/ Day/Year) |
3. Transaction Code |
4. Securities Acquired (A) or |
5. Amount of Securities Beneficially Owned at End of Month (Instr. 3 and 4) |
6. Ownership |
7. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code |
V |
Amount |
(A) or (D) |
Price |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) |
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1. Title of Derivative Security (Instr. 4) |
2. Conversion or Exercise Price of Derivative Security |
3. Transaction Date (Month/ Day/Year) |
4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned at End of Month (Instr. 4) |
10.Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
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Non-Statutory Stock Option |
$2.70 |
10/1/02 |
A |
2,000 |
D |
10/1/02 |
10/1/07 |
Common Stock |
2,000 |
14,000 |
D |
Non-Statutory Stock Option |
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Explanation of Responses: |
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** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. |
/s/ David Bailey |
11-27-02 |
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See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a) Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |
**Signature of Reporting Person |
Date |