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, 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) - ------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Joseph Lewis - ----------------------------------------------------------- (Last) (First) (Middle) c/o Cay House P.O. Box N7776 - ----------------------------------------------------------- (Street) Lyford Cay, New Providence, Bahamas - ----------------------------------------------------------- (City) (State) (Zip) - ------------------------------------------------------------------------------- 2. Date of Event Requiring Statement (Month/Day/Year) 12/16/99 - ------------------------------------------------------------------------------- 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) - ------------------------------------------------------------------------------- 4. Issuer Name and Ticker of Trading Symbol Dave & Busters, Inc./DAB - ------------------------------------------------------------------------------- 5. Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [X] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) -------------------------------------------------- - ------------------------------------------------------------------------------- 6. If Amendment, Date of Original (Month/Day/Year) - ------------------------------------------------------------------------------- 7. Individual or Joint/Group Filing (Check applicable line) [X] Form filed by One Reporting Person [ ] Form filed by More than One Reporting Person - ------------------------------------------------------------------------------- Page 1
FORM 3 (continued) TABLE I--Non-Derivative Securities Beneficially Owned - -------------------------------------------------------------------------------------------------------------------- 1. Title of Security 2. Amount of Securities 3. Ownership 4. Nature of Indirect Beneficial Onwership (Instr. 4) Beneficially Owned Form: Direct (Instr. 4) (Instr. 4) (D) or Indirect (I) (Instr. 5) - -------------------------------------------------------------------------------------------------------------------- - -------------------------------------------------------------------------------------------------------------------- Common Stock 1,342,600 I by Mandarin, Inc.* - -------------------------------------------------------------------------------------------------------------------- - -------------------------------------------------------------------------------------------------------------------- - -------------------------------------------------------------------------------------------------------------------- - -------------------------------------------------------------------------------------------------------------------- - -------------------------------------------------------------------------------------------------------------------- *If the Form is filed by more than one Reporting Person, see Instruction 5(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Page 2
FORM 3 (continued) TABLE II--Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) - ---------------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Date Exer- 3. Title and Amount of Securities 4. Conver- 5. Owner- 6. Nature of Security (Instr. 4) cisable and Underlying Derivative Security sion or ship Indirect Expiration (Instr. 4) Exercise Form of Beneficial Date ----------------------------------- Price of Deriv- Ownership (Month/Day/Year) Deriv- ative (Instr. 5) --------------------- Amount ative Security or Security Direct Date Expira- Title Number (D) or Exer- tion of Indirect cisable Date Shares (I) (Instr. 5) - ---------------------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------------------- Put (Obligation to buy) currently 2/2000 Common Stock 50,000 12.5 I by Mandarin, exercisable Inc.* - ---------------------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------------------- Explanation of Responses: *The securities reported herein are held by Mandarin, Inc. Joseph Lewis and Jane Lewis are the shareholders and directors of Mandarin, Inc. This filing shall not be deemed an admission that the Reporting Person is, for the purposes of Section 16 of the Securities and Exchange Act or otherwise, the beneficial owner of any securities covered by this statement. ** 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. /s/ Joseph Lewis 12/27/99 ---------------------------------------- ------------------ ** Signature of Reporting Person Date Page 3