SEC FORM
3
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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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
382 GREENWICH AVENUE |
SUITE ONE |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 03/13/2017
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3. Issuer Name and Ticker or Trading Symbol
NOODLES & Co
[ NDLS ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Class A Common Stock, $0.01 par value |
8,873,240 |
D
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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)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
1. Name and Address of Reporting Person*
382 GREENWICH AVENUE |
SUITE ONE |
(Street)
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1. Name and Address of Reporting Person*
382 GREENWICH AVENUE |
SUITE ONE |
(Street)
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1. Name and Address of Reporting Person*
382 GREENWICH AVENUE |
SUITE ONE |
(Street)
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1. Name and Address of Reporting Person*
382 GREENWICH AVENUE |
SUITE ONE |
(Street)
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Explanation of Responses: |
Remarks: |
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/s/ Scott P. Scharfman, Management Committee Director of sole general partner on behalf of Mill Road Capital II, L.P. |
03/23/2017 |
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/s/ Scott P. Scharfman, Management Committee Director on behalf of Mill Road Capital II GP LLC |
03/23/2017 |
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/s/ Scott P. Scharfman on behalf of Thomas E. Lynch by power of attorney |
03/23/2017 |
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/s/ Scott P. Scharfman |
03/23/2017 |
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** 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. |
Exhibit 24.1
CONFIRMING STATEMENT
This Statement confirms that the undersigned has authorized and designated
Scott P. Scharfman and Justin C. Jacobs, each acting singly, to execute and
file on the undersigned's behalf all Forms 3, 4 and 5 and Schedules 13D and
13G (including any amendments thereto) that the undersigned may be required
to file with the U.S. Securities and Exchange Commission as a result of the
undersigned's ownership of or transactions in securities of Noodles &
Company, a Delaware corporation. The authority of Scott P. Scharfman and
Justin C. Jacobs under this Statement shall continue until the undersigned
is no longer required to file any of Forms 3, 4 and 5 and Schedules 13D and
13G with regard to the undersigned's ownership of or transactions in
securities of Noodles & Company, unless earlier revoked in writing. The
undersigned acknowledges that Scott P. Scharfman and Justin C. Jacobs are
not assuming any of the undersigned's responsibilities to comply with
Section 16 or Section 13 of the Securities Exchange Act of 1934, as amended.
/s/ Thomas E. Lynch
Thomas E. Lynch
Dated: March 23, 2017
Exhibit 24.2
CONFIRMING STATEMENT
This Statement confirms that the undersigned has authorized and designated
Thomas E. Lynch and Justin C. Jacobs, each acting singly, to execute and
file on the undersigned's behalf all Forms 3, 4 and 5 and Schedules 13D and
13G (including any amendments thereto) that the undersigned may be required
to file with the U.S. Securities and Exchange Commission as a result of the
undersigned's ownership of or transactions in securities of Noodles &
Company, a Delaware corporation. The authority of Thomas E. Lynch and
Justin C. Jacobs under this Statement shall continue until the undersigned
is no longer required to file any of Forms 3, 4 and 5 and Schedules 13D and
13G with regard to the undersigned's ownership of or transactions in
securities of Noodles & Company, unless earlier revoked in writing. The
undersigned acknowledges that Thomas E. Lynch and Justin C. Jacobs are
not assuming any of the undersigned's responsibilities to comply with
Section 16 or Section 13 of the Securities Exchange Act of 1934, as amended.
/s/ Scott P. Scharfman
Scott P. Scharfman
Dated: March 23, 2017