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FORM 3
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U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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
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<S> <C> <C> <C>
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|1. Name and Address of Reporting Person* |2. Date of Event Requiring |4. Issuer Name and Ticker or Trading Symbol |
| | Statement | |
| Clay Dan | (Month/Day/Year) | |
|------------------------------------------| | Cooker Restaurant Corp. (CGR) |
| (Last) (First) (Middle) | |-----------------------------------------------------------|
| | 12/4/2000 |5. Relationship of Reporting | 6. If Amendment, Date |
| 2609 West End Avenue |---------------------------| Person to Issuer | of Original |
|------------------------------------------|3. IRS Identification | (Check all applicable) | (Month/Day/Year) |
| (Street) | Number of Reporting | | |
| | Person, if an entity |[ ] Director [ ] 10% Owner | |
| | (voluntary) | | |
| | |[X] Officer [ ] Other (specify| |
| | | (give below) |-------------------------|
| | | title below) | 7. Individual or Joint/ |
| Nashville, Tennessee 37203 | | Chief Operating Officer | Group Filing (Check |
|--------------------------------------------------------------------------------------------------------| applicable line) |
| (City) (State) (Zip) | |
| | [X] Form Filed by |
| | One Reporting |
| | Person |
| | [ ] Form Filed by |
| | More than One |
| | Reporting Person |
|----------------------------------------------------------------------------------------------------------------------------------|
| TABLE 1 -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED |
|----------------------------------------------------------------------------------------------------------------------------------|
|1. Title of Security | 2. Amount of Securities | 3. Ownership Form: | 4. Nature of Indirect |
| (Instr. 4) | Beneficially Owned | Direct (D) or | Beneficial |
| | (Instr. 4) | Indirect (I) | Ownership (Instr. 4) |
| | | (Instr. 5) | |
|----------------------------------------|------------------------------|---------------------------|------------------------------|
| None | | | |
|----------------------------------------|------------------------------|---------------------------|------------------------------|
| | | | |
|----------------------------------------|------------------------------|---------------------------|------------------------------|
| | | | |
|----------------------------------------|------------------------------|---------------------------|------------------------------|
| | | | |
|----------------------------------------|------------------------------|---------------------------|------------------------------|
| | | | |
|----------------------------------------|------------------------------|---------------------------|------------------------------|
| | | | |
|----------------------------------------|------------------------------|---------------------------|------------------------------|
| | | | |
|----------------------------------------|------------------------------|---------------------------|------------------------------|
| | | | |
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</TABLE>
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).
(Print or Type Responses)
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<CAPTION>
FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S> <C> <C> <C> <C> <C>
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| 1. Title of Derivative Security |2. Date |3. Title and Amount of |4. Conver- | 5. Owner- |6. Nature of Indirect|
| (Instr. 4) | Exercisable and | Securities Underlying | sion or | ship | Beneficial Owner- |
| | Expiration Date | Derivative Securities | Exercise | Form of | ship (Instr. 5) |
| | (Month/Day/Year )| (Instr. 4) | Price of | Deriva- | |
| | | | Deriva- | tive | |
| | | | tive | Security:| |
| | | | Security | Direct | |
| |--------------------|--------------------------| | (D) or | |
| | Date | Expira- | | Amount or | | Indirect | |
| | Exercis-| tion | Title | Number of | | (I) | |
| | able | Date | | Shares | | (Instr. | |
| | | | | | | 5) | |
|---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------|
|Stock Options (right to buy) | (1) | (1) | Common Stock | 150,000 | 1.125 | D | |
|---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------|
| | | | | | | | |
|---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------|
| | | | | | | | |
|---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------|
| | | | | | | | |
|---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------|
| | | | | | | | |
|---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------|
| | | | | | | | |
|---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------|
| | | | | | | | |
|---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------|
| | | | | | | | |
|---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------|
| | | | | | | | |
|---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------|
| | | | | | | | |
|---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------|
| | | | | | | | |
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Explanation of Responses:
(1) In connection with hiring the reporting person, the Company granted to the
reporting person options to purchase 150,000 shares of common stock which vest
equally over a 36-month period and expire ten years from the original grant.
/s/ Dan Clay 12/18/2000
** Intentional misstatements or omissions of facts constitute Federal Criminal --------------------------------- ----------
Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ** Signature of Reporting Person Date
Dan Clay
Note: File three copies of this Form, one of which must be manually signed.
If space provided is insufficient, see Instruction 6 for procedure.
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