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*
C/O JEFFERIES CAPITAL PARTNERS |
520 MADISON AVENUE, 10TH FLOOR |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 06/16/2009
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3. Issuer Name and Ticker or Trading Symbol
CARROLS RESTAURANT GROUP, INC.
[ TAST ]
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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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Common Stock
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6,559,739
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I |
See Footnote 1
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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*
C/O JEFFERIES CAPITAL PARTNERS |
520 MADISON AVENUE, 10TH FLOOR |
(Street)
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1. Name and Address of Reporting Person*
C/O JEFFERIES CAPITAL PARTNERS |
520 MADISON AVENUE, 10TH FLOOR |
(Street)
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1. Name and Address of Reporting Person*
C/O JEFFERIES CAPITAL PARTNERS |
520 MADISON AVENUE, 10TH FLOOR |
(Street)
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1. Name and Address of Reporting Person*
C/O JEFFERIES CAPITAL PARTNERS |
520 MADISON AVENUE, 10TH FLOOR |
(Street)
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1. Name and Address of Reporting Person*
C/O JEFFERIES CAPITAL PARTNERS |
520 MADISON AVENUE, 10TH FLOOR |
(Street)
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1. Name and Address of Reporting Person*
C/O JEFFERIES CAPITAL PARTNERS |
520 MADISON AVENUE, 10TH FLOOR |
(Street)
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1. Name and Address of Reporting Person*
C/O JEFFERIES CAPITAL PARTNERS |
520 MADISON AVENUE, 10TH FLOOR |
(Street)
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Explanation of Responses: |
Remarks: |
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/s/ Brian P. Friedman |
06/25/2009 |
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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 99
(1) Jefferies Capital Partners IV LLC ("Manager"), JCP IV LLC ("General
Partner"), Brian P. Friedman ("Mr. Friedman") and James L. Luikart ("Mr.
Luikart") may be deemed to own beneficially and indirectly the shares of
common stock, par value $.01 ("Common Stock"), of Carrols Restaurant Group,
Inc. (the "Company"), owned by (i) Jefferies Capital Partners IV L.P.
("Jefferies Capital Partners IV"), which beneficially owns 5,695,472 shares
of Common Stock; (ii) Jefferies Employee Partners IV LLC ("Jefferies
Employee Partners"), which beneficially owns 655,985 shares of Common
Stock; and (iii) JCP Partners IV LLC ("JCP Partners" and, together with
Jefferies Capital Partners IV and Jefferies Employee Partners,
collectively, "Jefferies Capital Partners" and, together with Manager,
General Partner, Mr. Friedman and Mr. Luikart, collectively, the "Reporting
Persons"), which beneficially owns 208,282 shares of Common Stock. General
Partner is the general partner of Jefferies Capital Partners IV and is the
managing member of each of Jefferies Employee Partners and JCP Partners,
and has the power to vote or direct the vote, and to dispose or direct the
disposition of, the shares of Common Stock reported herein which are deemed
owned by Jefferies Capital Partners, and, in such capacities, may be deemed
to beneficially own the shares of Common Stock reported herein which are
deemed owned by Jefferies Capital Partners. General Partner disclaims
beneficial ownership of the shares of Common Stock reported herein except
to the extent of its pecuniary interest therein. Manager is the manager of
Jefferies Capital Partners and the managing member of General Partner, and
has the power to vote or direct the vote, and to dispose or to direct the
disposition of, the shares of Common Stock reported herein which are deemed
owned by Jefferies Capital Partners, and, in such capacity, may be deemed
to beneficially own the shares of Common Stock reported herein which are
deemed owned by Jefferies Capital Partners. Manager disclaims beneficial
ownership of the shares of Common Stock reported herein except to the
extent of its pecuniary interest therein. Mr. Luikart and Mr. Friedman are
managing members of Manager, and, in such capacity, may be deemed to
beneficially own the shares of Common Stock reported herein which are
deemed owned by Jefferies Capital Partners. Mr. Luikart and Mr. Friedman
disclaim beneficial ownership of the shares of Common Stock reported herein
except to the extent of their pecuniary interest therein.
(2) On June 16, 2009, Jefferies Capital Partners entered into (i) a letter
agreement (the "Madison Purchase Agreement") with Madison Dearborn Capital
Partners, L.P. ("MDCP") and Madison Dearborn Capital Partners II, L.P.
("MDCP II" and, together with MDCP, "Madison"), pursuant to which Jefferies
Capital Partners IV agreed to purchase 2,457,025 shares of Common Stock
from Madison, Jefferies Employee Partners agreed to purchase 282,992 shares
of Common Stock from Madison and JCP Partners agreed to purchase 89,852
shares of Common Stock from Madison and (ii) a letter agreement (the "BIB
Purchase Agreement" and, together with the Madison Purchase Agreement, the
"Purchase Agreements") with BIB Holdings (Bermuda), Ltd. ("BIB"), pursuant
to which Jefferies Capital Partners IV agreed to purchase 3,238,447 shares
of Common Stock from BIB, Jefferies Employee Partners agreed to purchase
372,993 shares of Common Stock from BIB and JCP Partners agreed to purchase
118,430 shares of Common Stock from BIB. Jefferies Capital Partners will
receive the shares of Common Stock reported herein upon the consummation of
the transactions contemplated by the Purchase Agreements on or about July
2, 2009.
(3) Jefferies & Company, Inc. ("Jefferies") beneficially owned 228,500 shares
of Common Stock as of June 16, 2009. Jefferies Group, Inc. ("Group") may be
deemed to beneficially own the shares of Common Stock owned by Jefferies.
Each of Jefferies and Group may be considered an affiliate of the Reporting
Persons for purposes of Section 13 of the Securities Exchange Act of 1934,
as amended (the "Exchange Act"). Jefferies Capital Partners and Jefferies
entered into an agreement, dated as of June 16, 2009, which contemplates
certain arrangements relating to the Common Stock. Each of the Reporting
Persons expressly disclaims (i) beneficial ownership of the shares of
Common Stock beneficially owned or that may be beneficially owned by
Jefferies and/or Group and (ii) that the Reporting Persons and Jefferies
and/or Group constitute a "group" for purposes of Section 13 of the
Exchange Act.
JEFFERIES CAPITAL PARTNERS IV L.P.
JEFFERIES EMPLOYEE PARTNERS IV LLC
JCP PARTNERS IV LLC
By: JEFFERIES CAPITAL PARTNERS IV LLC,
as Manager
By: /s/ Brian P. Friedman
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Name: Brian P. Friedman
Title: Managing Member
JCP IV LLC
By: JEFFERIES CAPITAL PARTNERS IV LLC,
as Managing Member
By: /s/ Brian P. Friedman
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Name: Brian P. Friedman
Title: Managing Member
JEFFERIES CAPITAL PARTNERS IV LLC
By: /s/ Brian P. Friedman
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Name: Brian P. Friedman
Title: Managing Member
/s/ Brian P. Friedman
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Brian P. Friedman
/s/ James L. Luikart
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James L. Luikart