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FORM 4
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[ ] Check this box if no longer subject _________________________________
to Section 16. Form 4 or Form 5 | OMB Number: 3235-0287 |
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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
(Print or Type Responses)
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1. Name and Address of Reporting Person*
Mandarin, Inc.
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(Last) (First) (Middle)
c/o Cay House, P.O. Box N7776
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(Street)
Lyford Cay, New Providence, Bahamas
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Dave & Busters, Inc. (DAB)
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
12/1999
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[ ] Director [X] 10% Owner
[ ] Officer (give title below) [ ] Other (specify below)
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<TABLE>
<CAPTION>
TABLE I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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5. Amount of 6. Owner-
Securities ship
2. Trans- 3. Trans- 4. Securities Acquired (A) Beneficially Form:
action action or Disposed of (D) Owned at Direct 7. Nature of
Date Code (Instr. 3, 4 and 5) End of (D) or Indirect
1. Title of Security (Month/ (Instr. 8) -------------------------- Month Indirect Beneficial
(Instr. 3) Day/ ---------- Amount (A) or Price (Instr. (I) Ownership
Year) Code V (D) 3 and 4) (Instr. 4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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Common Stock 12/20/1999 P 29,500 A $6.1928 1,372,100 D
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (over)
* If the form is filed by more than one person, see Instruction 4(b)(v). SEC 1474 (7-96)
</TABLE>
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FORM 4 (continued)
<TABLE>
<CAPTION>
TABLE II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g. puts, calls, warrants, options, convertible securities)
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1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
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Title and Ownership
Number of Date Exer- Amount of Form of
Derivative cisable and Underlying Number of Deriv-
Securities Expiration Securities Price Derivative ative
Conver- Trans- Acquired (A) Date (Month/ (Instr. 3 of Securities Security:
sion or Trans- action or Disposed Day/Year) and 4) Deriv- Benefi- Direct
Exercise action Code of (D) -------------- -------------- ative cially (D) or Nature of
Title of Price of Date (Instr. (Instr. 3, Date Amount Secur- Owned at Indirect Indirect
Derivative Deriv- (Month/ 8) 4 and 5) Exer- Expir- or Num- ity End of (I) Beneficial
Security ative Day/ -------- ---------- cis- ation ber of (Instr. Month (Instr. Ownership
(Instr. 3) Security Year) Code V (A) (D) able Date Title Shares 5) (Instr. 4) 4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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Put Options
(obligation Common
to buy) $5 12/21/1999 S 300 (1) 5/2000 Stock 30,000 7/8 300 D
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Put
(obligation Common
to buy) (2) $12.5 500 (1) 2/00 Stock 50,000 500 D
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</TABLE>
Explanation of Responses:
(1) Currently exercisable.
(2) Previously reported.
/s/ Joseph Lewis 1/7/00
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** Signature of Reporting Person Date
** 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 provided is insufficient, see Instruction 6 for procedure.
