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