0001866581-24-000072.txt : 20240311 0001866581-24-000072.hdr.sgml : 20240311 20240311185230 ACCESSION NUMBER: 0001866581-24-000072 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240308 FILED AS OF DATE: 20240311 DATE AS OF CHANGE: 20240311 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jemley Charles CENTRAL INDEX KEY: 0001716761 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40798 FILM NUMBER: 24739660 MAIL ADDRESS: STREET 1: C/O FOUR CORNERS PROPERTY TRUST, INC. STREET 2: 591 REDWOOD HIGHWAY, SUITE 1150 CITY: MILL VALLEY STATE: CA ZIP: 94941 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_1710197539.xml FORM 4 X0508 4 2024-03-08 0 0001866581 Dutch Bros Inc. BROS 0001716761 Jemley Charles C/O DUTCH BROS INC. PO BOX 1929 GRANTS PASS OR 97528-0163 0 1 0 0 Chief Financial Officer 0 Class A Common Stock 2024-03-08 4 G 0 169603 0 D 0 D Class A Common Stock 2024-03-08 4 G 0 169603 0 A 1070032 I By Jemley Living Trust dtd 6/24/2022 On March 8, 2024, the reporting person transferred 169,603 shares to the Jemley Living Trust dtd 6/24/2022, of which the reporting person is a trustee and has voting and dispositive power over the shares. Held by the Jemley Living Trust dtd 6/24/2022, of which the reporting person is a trustee and has voting and dispositive power over the shares. /s/ Joshua Lute, Attorney-in-Fact for Charles L Jemley 2024-03-11