0000899243-21-030372.txt : 20210728 0000899243-21-030372.hdr.sgml : 20210728 20210728171134 ACCESSION NUMBER: 0000899243-21-030372 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210726 FILED AS OF DATE: 20210728 DATE AS OF CHANGE: 20210728 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Simms Lorna R. CENTRAL INDEX KEY: 0001871807 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40630 FILM NUMBER: 211123431 MAIL ADDRESS: STREET 1: 15821 VENTURA BLVD., SUITE 145 CITY: ENCINO STATE: CA ZIP: 91436 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Zevia PBC CENTRAL INDEX KEY: 0001854139 STANDARD INDUSTRIAL CLASSIFICATION: BOTTLED & CANNED SOFT DRINKS CARBONATED WATERS [2086] IRS NUMBER: 862862492 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 15821 VENTURA BLVD. STREET 2: SUITE 145 CITY: ENCINO STATE: CA ZIP: 91436 BUSINESS PHONE: (310) 202-7000 MAIL ADDRESS: STREET 1: 15821 VENTURA BLVD. STREET 2: SUITE 145 CITY: ENCINO STATE: CA ZIP: 91436 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-07-26 0 0001854139 Zevia PBC ZVIA 0001871807 Simms Lorna R. C/O ZEVIA PBC 15821 VENTURA BLVD., SUITE 145 ENCINO CA 91436 0 1 0 0 See Remarks Class A Common Stock 2021-07-26 4 P 0 150 14.00 A 52150 D Represents shares purchased in the Issuer's reserved share program in connection with the closing of the Issuer's initial public offering (the "IPO"). Includes 52,000 outstanding restricted stock units which vest in full on the earliest to occur of (i) the date that is six months after the IPO, (ii) the termination of the lockup period following the IPO or (iii) the consummation of a change in control of the Issuer, subject to the Reporting Person's continued service to the Issuer. Senior VP, General Counsel and Corporate Secretary /s/ Lorna R. Simms 2021-07-28