0001866581-23-000064.txt : 20230403
0001866581-23-000064.hdr.sgml : 20230403
20230403185836
ACCESSION NUMBER: 0001866581-23-000064
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230331
FILED AS OF DATE: 20230403
DATE AS OF CHANGE: 20230403
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Davis Thomas James
CENTRAL INDEX KEY: 0001884188
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40798
FILM NUMBER: 23794460
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
wf-form4_168056270419980.xml
FORM 4
X0407
4
2023-03-31
0
0001866581
Dutch Bros Inc.
BROS
0001884188
Davis Thomas James
C/O DUTCH BROS INC.
PO BOX 1929
GRANTS PASS
OR
97528-0163
1
0
0
0
0
Class A Common Stock
2023-03-31
4
M
0
627
0
A
1881
D
Restricted Stock Units
2023-03-31
4
M
0
627
0
D
Class A Common Stock
627.0
628
D
The restricted stock units represent a contingent right to receive a corresponding number of shares of the Class A Common Stock of the Issuer upon vesting.
The reporting person received an award of restricted stock units, 25% of which will vest on each of September 30, 2022, December 31, 2022, March 31, 2023, and the remaining 25% will vest on the earlier of (i) June 30, 2023, and (ii) the date of the Issuer's 2023 annual stockholder meeting.
/s/ Joshua Lute, Attorney-in-Fact for Thomas J Davis
2023-04-03