0001866581-24-000056.txt : 20240304 0001866581-24-000056.hdr.sgml : 20240304 20240304124101 ACCESSION NUMBER: 0001866581-24-000056 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240301 FILED AS OF DATE: 20240304 DATE AS OF CHANGE: 20240304 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tullett Victoria J CENTRAL INDEX KEY: 0001606719 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40798 FILM NUMBER: 24713907 MAIL ADDRESS: STREET 1: C/O DUTCH BROS INC. STREET 2: 110 SW 4TH STREET CITY: GRANTS PASS STATE: OR ZIP: 97526 FORMER NAME: FORMER CONFORMED NAME: Blackwell Victoria T. DATE OF NAME CHANGE: 20140429 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Dutch Bros Inc. CENTRAL INDEX KEY: 0001866581 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING & DRINKING PLACES [5810] ORGANIZATION NAME: 07 Trade & Services IRS NUMBER: 871041305 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 110 SW 4TH STREET CITY: GRANTS PASS STATE: OR ZIP: 97526 BUSINESS PHONE: (206) 390-8860 MAIL ADDRESS: STREET 1: PO BOX 1929 CITY: GRANTS PASS STATE: OR ZIP: 97528-0163 4 1 wk-form4_1709574052.xml FORM 4 X0508 4 2024-03-01 0 0001866581 Dutch Bros Inc. BROS 0001606719 Tullett Victoria J C/O DUTCH BROS INC. PO BOX 1929 GRANTS PASS OR 97528-0163 0 1 0 0 Chief Legal Officer 0 Restricted Stock Units 2024-03-01 4 A 0 26963 0 A Class A Common Stock 26963 26963 D Each restricted stock unit represents a contingent right to receive one share of the Issuer's Class A Common Stock. The reporting person received an award of restricted stock units, 33.33% of which will vest on each of March 1, 2025, March 1, 2026, and March 1, 2027. /s/ Joshua Lute, Attorney-in-Fact for Victoria Tullett 2024-03-04