0001104659-23-126518.txt : 20231215 0001104659-23-126518.hdr.sgml : 20231215 20231215203958 ACCESSION NUMBER: 0001104659-23-126518 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231214 FILED AS OF DATE: 20231215 DATE AS OF CHANGE: 20231215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Boersma Travis CENTRAL INDEX KEY: 0001883154 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40798 FILM NUMBER: 231491999 MAIL ADDRESS: STREET 1: C/O DUTCH BROS INC. STREET 2: PO BOX 1929 CITY: GRANTS PASS STATE: OR ZIP: 97528 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Dutch Bros Inc. CENTRAL INDEX KEY: 0001866581 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING & DRINKING PLACES [5810] 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 tm2333077-2_4seq1.xml OWNERSHIP DOCUMENT X0508 4 2023-12-14 0 0001866581 Dutch Bros Inc. BROS 0001883154 Boersma Travis C/O DUTCH BROS INC. 110 SW 4TH STREET GRANTS PASS OR 97526 1 1 1 0 Executive Chairman of Board 1 Class A Common Stock 2023-12-14 4 S 0 248346 30.4618 D 2265895 I By DM Trust Aggregator, LLC Class A Common Stock 2023-12-14 4 S 0 156183 30.3815 D 1425003 I By DM Individual Aggregator, LLC As indicated by the checkbox above, this transaction was effected automatically pursuant to a Rule 10b5-1 trading plan adopted by DM Trust Aggregator, LLC on August 15, 2023. As indicated by the checkbox above, this transaction was effected automatically pursuant to a Rule 10b5-1 trading plan adopted by DM Individual Aggregator, LLC on August 15, 2023. Represents the weighted average sale price. These shares were sold in multiple transactions at prices ranging from $30.0000 to $30.7800 inclusive. The reporting person undertakes to provide the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth above. /s/ Thomas P. Conaghan, Attorney-in-Fact for Travis Boersma 2023-12-15