SEC Form 3
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
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Prior Jane

(Last) (First) (Middle)
250 PARK AVENUE SOUTH, 7TH FLOOR

(Street)
NEW YORK NY 10003

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/21/2021
3. Issuer Name and Ticker or Trading Symbol
Vita Coco Company, Inc. [ COCO ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Marketing Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 112.98 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) (1) 02/01/2023 Common Stock 18,655 $6.418 D
Stock Option (Right to Buy) (2) 12/16/2029 Common Stock 129,675 $10.178 D
Stock Option (Right to Buy) (3) 02/10/2030 Common Stock 113,750 $10.178 D
Stock Option (Right to Buy) (4) 01/11/2031 Common Stock 18,200 $10.178 D
Stock Options (Right to Buy) (5) 10/20/2031 Common Stock 45,605 $15 D
Explanation of Responses:
1. The stock option is fully vested and currently exercisable.
2. The stock option is fully vested and currently exercisable with respect to 98,735 underlying shares. The remainder will vest in two installments on November 1, 2021 (with respect to 17,209 underlying shares) and August 1, 2022 (with respect to 13,650 underlying shares).
3. The stock option vests in two equal biennial installments beginning on February 10, 2022.
4. The stock option vests in two equal biennial installments beginning on January 11, 2023.
5. The stock option vests in four equal annual installments beginning on November 27, 2022.
Remarks:
Exhibit 24 - Power of Attorney.
/s/ Yolanda Goettsch, Attorney-in-fact 10/21/2021
** Signature of Reporting Person Date
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).
** 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.