0001179110-21-010927.txt : 20211214
0001179110-21-010927.hdr.sgml : 20211214
20211214121144
ACCESSION NUMBER: 0001179110-21-010927
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20211213
FILED AS OF DATE: 20211214
DATE AS OF CHANGE: 20211214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Anderson Janelle Denise
CENTRAL INDEX KEY: 0001899092
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41147
FILM NUMBER: 211490182
MAIL ADDRESS:
STREET 1: 505 HIGHWAY 169 NORTH
STREET 2: SUITE 255
CITY: PLYMOUTH
STATE: MN
ZIP: 55441
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Fresh Vine Wine, Inc.
CENTRAL INDEX KEY: 0001880343
STANDARD INDUSTRIAL CLASSIFICATION: BEVERAGES [2080]
IRS NUMBER: 834709895
STATE OF INCORPORATION: TX
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 505 HIGHWAY 169 NORTH, SUITE 255
CITY: PLYMOUTH
STATE: MN
ZIP: 55441
BUSINESS PHONE: 855-766-9463
MAIL ADDRESS:
STREET 1: 505 HIGHWAY 169 NORTH, SUITE 255
CITY: PLYMOUTH
STATE: MN
ZIP: 55441
FORMER COMPANY:
FORMER CONFORMED NAME: FRESH GRAPES, LLC
DATE OF NAME CHANGE: 20210826
3
1
edgar.xml
FORM 3 -
X0206
3
2021-12-13
0
0001880343
Fresh Vine Wine, Inc.
VINE
0001899092
Anderson Janelle Denise
505 HIGHWAY 169 NORTH
SUITE 255
PLYMOUTH
MN
55441
1
1
0
0
CEO
Common Stock, $.001 par value
67676
D
Exhibit 24.1 Power of Attorney filed herewith.
/s/ Janelle Anderson
2021-12-13
EX-24.1
2
andersonpoa.txt
POWER OF ATTORNEY
Power of Attorney
KNOW ALL MEN BY THESE PRESENTS, that the undersigned hereby
constitutes and appoints JANELLE ANDERSON and ELLIOT SAVOIE,
signing singly, as his or her lawful attorney-in-fact and agent,
with full power of substitution and re-substitution, for his/her
and in his/her name, place and stead, in any and all capacities
(until revoked in writing) to:
1. Sign any and all instruments, certificates and documents
appropriate or required to be executed on behalf of the
undersigned pursuant to sections 13 and 16 of the
Securities Exchange Act of 1934, as amended (the
"Exchange
Act"), and any and all regulations promulgated
thereunder,
and to file the same, with all exhibits thereto, and any
other documents in connection therewith, with the
Securities and Exchange Commission (the "SEC"), and with
any other entity when and if such is mandated by the
Exchange Act or by the Bylaws of the Financial Industry
Regulatory Authority;
2. prepare, execute, acknowledge, deliver and file a Form ID
(including any amendments or authentications thereto)
with
respect to obtaining EDGAR codes, with the SEC; and
3. perform any and all other acts which in the discretion of
such attorneys-in-fact are necessary or desirable for and
on behalf of the undersigned in connection with the
foregoing.
The undersigned acknowledges that:
1. this Power of Attorney authorizes, but does not require,
such attorneys-in-fact to act in their discretion on
information provided to such attorneys-in-fact without
independent verification of such information;
2. any documents prepared and/or executed by such attorneys-
in-fact on behalf of the undersigned pursuant to this
Power
of Attorney will be in such form and will contain such
information and disclosure as such attorney-in-fact, in
his or her discretion, deems necessary or desirable;
3. no such attorneys-in-fact assumes (a) any liability for
responsibility to comply with the requirements of the
Exchange Act for any of the undersigned, (b) any
liability
for any failure to comply with such requirements for any
of the undersigned, or (c) any obligation or liability
for
profit disgorgement under Section 16(b) of the Exchange
Act for the undersigned; and
4. this Power of Attorney does not relieve the undersigned
from responsibility for compliance with the undersigned's
obligations under the Exchange Act, including without
limitation the reporting requirements under Sections 13
and 16 of the Exchange Act.
The undersigned hereby gives and grants the foregoing attorneys-
in-fact full power and authority to do and perform all and every
act and thing whatsoever requisite, necessary or appropriate to
be
done in and about the foregoing matters as fully to all intents
and purposes as the undersigned might or could do if present,
with
full power of substitution and revocation, hereby ratifying all
that such attorney-in-fact, or such attorney-in-fact's
substitute
or substitutes, of, for and on behalf of the undersigned, shall
lawfully do or cause to be done by virtue of this Power of
Attorney.
This Power of Attorney shall remain in full force and effect
until revoked by the undersigned in a signed writing delivered
to such attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power
of
Attorney to be executed as of this December 1, 2021.
/s/ Janelle Anderson
(signature)
Janelle Anderson
(name printed)
NY 247807733v1