SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 10/01/2021 | 3. Issuer Name and Ticker or Trading Symbol First Watch Restaurant Group, Inc. [ FWRG ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Option (right to buy) | (1) | 07/18/2028 | Common stock | 177,570(1) | 8.45 | D | |
Stock Option (right to buy) | (2) | 04/24/2029 | Common stock | 69,055(2) | 12.68 | D |
Explanation of Responses: |
1. Represents stock options awarded on July 18, 2018, pursuant to the Issuer's 2017 Omnibus Equity Incentive Plan (the "Plan"). Unvested stock options vest in installments as follows: (a) 21,308 options on each of July 18, 2022 and the first anniversary thereof; and (b) 23,676 options on each of the first two anniversaries of the closing of the Issuer's initial public offering (the "IPO") and on the 273rd day following the second anniversary of the closing of the IPO, subject to earlier forfeiture or acceleration. |
2. Represents stock options awarded on April 24, 2019, pursuant to the Plan. Unvested stock options vest in installments as follows: (a) 8,286 options on April 24, 2022, and 8,287 options on each of the first two anniversaries thereof; and (b) 9,207 options on each of the first two anniversaries of the closing of the IPO, and 9,208 options on the 273rd day following the second anniversary of the closing of the IPO, subject to earlier forfeiture or acceleration. |
Remarks: |
Exhibit 24 - Power of Attorney, incorporated herein by reference |
By: /s/ Jay Wolszczak | 10/01/2021 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations 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. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |