# EDGAR Filing Document

**Accession Number:** 0001653247
**File Stem:** 0001653247-23-000002
**Filing Date:** 2023-1
**Character Count:** 9253
**Document Hash:** 975f65032191fb003796c15b671a2b10
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001653247-23-000002.hdr.sgml**: 20230104

**ACCESSION NUMBER**: 0001653247-23-000002

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230103

**FILED AS OF DATE**: 20230104

**DATE AS OF CHANGE**: 20230104

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** GRIMSTAD CARL A
- **CENTRAL INDEX KEY:** 0001239359

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-37788
- **FILM NUMBER:** 23507402
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Waitr Holdings Inc.
- **CENTRAL INDEX KEY:** 0001653247
- **STANDARD INDUSTRIAL CLASSIFICATION:** SERVICES-BUSINESS SERVICES, NEC [7389]
- **IRS NUMBER:** 263828008
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 214 JEFFERSON STREET
- **STREET 2:** SUITE 200
- **CITY:** LAFAYETTE
- **STATE:** LA
- **ZIP:** 70501
- **BUSINESS PHONE:** 1-337-534-6881

**MAIL ADDRESS:**
- **STREET 1:** 214 JEFFERSON STREET
- **STREET 2:** SUITE 200
- **CITY:** LAFAYETTE
- **STATE:** LA
- **ZIP:** 70501

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** Landcadia Holdings, Inc.
- **DATE OF NAME CHANGE:** 20150916

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>GRIMSTAD CARL A<br><sub>(Last) (First) (Middle)</sub><br>C/O WAITR HOLDINGS INC.<br>214 JEFFERSON STREET, SUITE 200<br><sub>(Street)</sub><br>LAFAYETTE, LA 70501<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-01-03 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_Chief Executive Officer_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>Waitr Holdings Inc. [ ASAP ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock | 2023-01-03 |  | M |  | 58333 | A | $0 | 58333 | D |  |
| Common Stock | 2023-01-03 |  | F |  | 17296 | D | $0 | 41037 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Restricted Stock Units (RSUs) - 042321<sup>(1)</sup> | <sup>(2)</sup> | 2023-01-03 |  | M |  |  | 58333 | <sup>(2)</sup> | <sup>(2)</sup> | Common Stock | 58333.0 | $0 | 116667 | D |  |
| Restricted Stock Units (RSUs) - 041122<sup>(1)</sup> | <sup>(3)</sup> |  |  |  |  |  |  | <sup>(3)</sup> | <sup>(3)</sup> | Common Stock | 200000.0 |  | 200000 | D |  |
| Restricted Stock Units (RSUs) - 042320<sup>(1)</sup> | <sup>(4)</sup> |  |  |  |  |  |  | <sup>(4)</sup> | <sup>(4)</sup> | Common Stock | 156716.0 |  | 156716 | D |  |
| Stock Options - 010320<sup>(1)</sup> | 7.4<sup>(5)</sup> |  |  |  |  |  |  | <sup>(5)</sup> | 2025-01-03 | Common Stock | 478620.0 |  | 478620 | D |  |

---

### Footnotes:

(1) On November 22, 2022, the Issuer effected a one-for-twenty reverse stock split (the "Reverse Stock Split") of all of its issued and outstanding shares of common stock.  The Reverse Stock Split also impacted outstanding derivative securities issued pursuant to the Issuer's 2018 Amended and Restated Omnibus Incentive Plan, which resulted in the Reporting Person's ownership of derivative securities being adjusted accordingly.

(2) Each RSU represents a contingent right to receive one share of the Issuer's common stock. The grant of 175,000 RSUs (as adjusted for the Reverse Stock Split) was made to the Reporting Person on April 23, 2021. The RSUs shall vest in three generally equal installments on the first, second and third anniversaries of January 3, 2022, subject to the Reporting Person's continued employment through the applicable vesting date; provided further, that, the RSUs vest upon (i) a Corporate Change (as defined in the Reporting Person's employment agreement), subject to the Reporting Person's continued employment through the closing of such Corporate Change, (ii) termination by the Reporting Person of the employment agreement for Good Reason (as defined therein), or (iii) termination by the Company of the employment agreement for other than Misconduct (as defined therein).

(3) Each RSU represents a contingent right to receive one share of the Issuer's common stock. The grant of 200,000 RSUs (as adjusted for the Reverse Stock Split) was made to the Reporting Person on April 11, 2022. The RSUs shall vest in three generally equal installments on the first, second and third anniversaries of such grant date, subject to the Reporting Person's continued employment through the applicable vesting date; provided further, that, the RSUs vest upon (i) a Corporate Change (as defined in the Reporting Person's employment agreement), subject to the Reporting Person's continued employment through the closing of such Corporate Change, (ii) termination by the Reporting Person of the employment agreement for Good Reason (as defined therein), or (iii) termination by the Company of the employment agreement for other than Misconduct (as defined therein).

(4) Each RSU represents a contingent right to receive one share of the Issuer's common stock. The RSUs shall vest upon the consummation of a Corporate Change (as defined in the Reporting Person's employment agreement), provided that the employment agreement has not been previously terminated; provided further, that, the RSUs shall fully vest upon the termination of the employment agreement by the Reporting Person for Good Reason (as defined therein) of by the Company for reason other than Misconduct (as defined therein).

(5) The Reporting Person's right to purchase the shares of the Issuer's common stock vested and became exercisable as follows: (i) 1/2 of the option vested and became exercisable on January 3, 2021 and (ii) 1/2 of the option vested and became exercisable on January 2, 2022. The exercise price of the stock options has been adjusted for the Reverse Stock Split.

**Signature:** /s/ Annette Finch, Attorney-in-Fact  
**Date:** 2023-01-04

### Remarks:

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).

** 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.**