0001866581-24-000121.txt : 20240423
0001866581-24-000121.hdr.sgml : 20240423
20240423123345
ACCESSION NUMBER: 0001866581-24-000121
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240419
FILED AS OF DATE: 20240423
DATE AS OF CHANGE: 20240423
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DM Trust Aggregator, LLC
CENTRAL INDEX KEY: 0001883105
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40798
FILM NUMBER: 24863515
BUSINESS ADDRESS:
STREET 1: 110 SW 4TH STREET
CITY: GRANTS PASS
STATE: OR
ZIP: 97526
BUSINESS PHONE: (541) 659-0387
MAIL ADDRESS:
STREET 1: PO BOX 398
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]
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_1713890016.xml
FORM 4
X0508
4
2024-04-19
0
0001866581
Dutch Bros Inc.
BROS
0001883105
DM Trust Aggregator, LLC
PO BOX 398
GRANTS PASS
OR
97526
0
0
1
0
0
Class A Common Stock
2024-04-19
4
C
0
1150326
0
A
2201504
D
Class B Common Stock
2024-04-19
4
C
0
1150326
0
D
35307815
D
Class A Common Units
2024-04-19
4
C
0
1150326
0
D
Class A Common Stock
1150326
35307815
D
Pursuant to the Third Amended and Restated Limited Liability Company Agreement of Dutch Mafia, LLC ("Dutch Mafia"), dated September 14, 2021, Class A Common Units of Dutch Mafia, together with an equal number of shares of Class B Common Stock of the Issuer are exchangeable for shares of Class A Common Stock on a one-for-one basis at the discretion of the holder, subject to certain exceptions, conditions and adjustments. Upon such exchange, the associated shares of Class B Common Stock are surrendered and canceled by the Issuer. The Class A Common Units of Dutch Mafia and the Class B Common Stock of the Issuer do not have an expiration date and the holders thereof are not required to pay an exercise price in connection with exchanges. On April 19, 2024, the Reporting Person exchanged 1,150,326 Class A Common Units for 1,150,326 shares of Class A Common Stock of the Issuer, and the corresponding number of shares of Class B Common Stock were canceled by the Issuer.
Represents Class A Common Units of Dutch Mafia, the operating company of the Issuer.
/s/ Thomas P. Conaghan, Attorney-in-Fact for Travis Boersma, Manager
2024-04-23