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FORM 4
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
[ ] Check this box if no
longer subject to Filed pursuant to Section 16(a) of the Securities
Section 16. Form 4 Exchange Act of 1934, Section 17(a) of the
or Form 5 obligations Public Utility Holding Company Act of 1935
may continue. See or Section 30(f) of the Investment Company
Instruction 1(b). Act of 1940
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<S> <C> <C> <C> <C> <C> <C>
(Print or Type Responses)
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| 1. Name and Address of Reporting Person* | 2. Issuer Name and Ticker or Trading Symbol |6. Relationship of Reporting Person(s)|
| Mikosz Mark W. | Cooker Restaurant Corporation (CGR) | to Issuer (Check all applicable) |
|--------------------------------------------|----------------------------------------------| |
| (Last) (First) (Middle) | 3. IRS Identification | 4. Statement For | [ ] Director [ ] 10% Owner |
| | Number of Reporting | Month/Year | [X] Officer (give [ ] Other (Specify|
| | Person, if an Entity | | title below) |
| Cooker Restaurant Corporation | (Voluntary) | 11/00 | below) |
| 5500 Village Blvd. | | | Chief Financial Officer |
|--------------------------------------------| |--------------------|--------------------------------------|
| (Street) | | 5. If Amendment, |7. Individual or Joint/Group Filing |
| | | Date of Original| (Check applicable line) |
| | | (Month/Year) | [X] Form Filed by One |
| West Palm Beach FL 33407 | | | Reporting Person |
|--------------------------------------------|----------------------------------------------| [ ] Form Filed by More Than |
| (City) (State) (Zip) | | One Reporting Person |
| | | |
|----------------------------------------------------------------------------------------------------------------------------------|
| TABLE 1 -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED |
|----------------------------------------------------------------------------------------------------------------------------------|
|1. Title of Security |2. Transaction |3. Transac- |4. Securities Acquired (A) | 5. Amount of Se- |6. Owner- |7. Nature |
| (Instr. 3) | Date | tion Code | or Disposed of (D) | curities Benefi-| ship | of In- |
| | (Month/Day/ | (Instr. 8) | | cially Owned at | Form: | direct |
| | Year) | | | End of Month | Direct | Benefi-|
| | | | (Instr. 3, 4 and 5) | (Instr. 3 and 4)| (D) or | cial |
| | |--------------|---------------------------| | Indirect | Owner- |
| | | Code | V | Amount | (A) or| Price| | (I) | ship |
| | | | | | (D) | | | (Instr. 4)| (Instr.|
| | | | | | | | | | 4) |
|---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------|
| | | | | | | | | | |
|---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------|
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|---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------|
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|---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------|
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|---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------|
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|---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------|
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|---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------|
| | | | | | | | | | |
|---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------|
| | | | | | | | | | |
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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 4(b)(v).
Potential persons who are to respond to the collection of (Over)
information contained in this form are not required to respond SEC 1474 (3-99)
unless the form displays a currently valid OMB control number.
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<TABLE>
<CAPTION>
FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S> <C> <C> <C> <C> <C> <C> <C>
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|1. Title of Derivative | 2. Conver- |3. Trans- |4. Trans- |5. Number of | 6. Date Exer- |7. Title and Amount |8. Price |
| Security | sion or | action | action | Derivative | cisable and | of Underlying | of |
| (Instr. 3) | Exercise | Date | Code | Securities | Expiration | Securities | Deriv- |
| | Price of | (Month/| (Instr.| Acquired (A) | Date | (Instr. 3 and 4) | ative |
| | Deriv- | Day/ | 8) | or Disposed | (Month/Day/ | | Secur- |
| | ative | Year) | | of (D) | Year) | | ity |
| | Security | | | (Instr. 3, | | | (Instr. 5)|
| | | | | 4, and 5) |-----------------|--------------------| |
| | | | | | Date |Expira- | | Amount or| |
| | | |----------|----------------| Exer- |tion | Title | Number of| |
| | | | Code| V | (A) | (D) | cisable|Date | | Shares | |
|-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------|
| Options (right to buy)| $1.00 |11/22/2000| A | V |37,000 | | (1) | 11/23/ | common | 37,000 | |
| | | | | | | | | 2010 | stock | | |
|-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------|
| | | | | | | | | | | | |
|-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------|
| | | | | | | | | | | | |
|-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------|
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|-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------|
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|-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------|
| | | | | | | | | | | | |
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<CAPTION>
<S> <C> <C>
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| 9. Number of | 10. Ownership | 11. Nature of |
| Derivative | Form of | Indirect |
| Securities | Derivative | Beneficial |
| Beneficially | Security: | Ownership |
| Owned at End | Direct (D) | (Instr. 4) |
| of Month | or Indirect (I) | |
| (Instr. 4) | (Instr. 4) | |
| | | |
|---------------------|-------------------------------|----------------------|
| 37,000 | D | |
| | | |
|---------------------|-------------------------------|----------------------|
| | | |
|---------------------|-------------------------------|----------------------|
| | | |
|---------------------|-------------------------------|----------------------|
| | | |
|---------------------|-------------------------------|----------------------|
| | | |
|---------------------|-------------------------------|----------------------|
| | | |
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Explanation of Responses:
(1) The option becomes exercisable in four equal annual installments beginning on November 22, 2001.
** Intentional misstatements or omissions of facts constitute Federal Criminal /s/ Mark W. Mikosz 12/05/2000
Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ------------------------------- ----------
**Signature of Reporting Person Date
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.
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