0001437749-22-000939.txt : 20220114 0001437749-22-000939.hdr.sgml : 20220114 20220114162842 ACCESSION NUMBER: 0001437749-22-000939 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220103 FILED AS OF DATE: 20220114 DATE AS OF CHANGE: 20220114 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SIRKIN CLIVE M CENTRAL INDEX KEY: 0001673527 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28820 FILM NUMBER: 22532161 MAIL ADDRESS: STREET 1: ONE KELLOGG SQUARE STREET 2: PO BOX 3599 CITY: BATTLE CREEK STATE: MI ZIP: 49016-3599 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: JONES SODA CO CENTRAL INDEX KEY: 0001083522 STANDARD INDUSTRIAL CLASSIFICATION: BEVERAGES [2080] IRS NUMBER: 911696175 STATE OF INCORPORATION: WA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 66 S HANFORD ST STREET 2: SUITE 150 CITY: SEATTLE STATE: WA ZIP: 98134 BUSINESS PHONE: 206 624-3357 MAIL ADDRESS: STREET 1: 66 S HANFORD ST STREET 2: SUITE 150 CITY: SEATTLE STATE: WA ZIP: 98134 FORMER COMPANY: FORMER CONFORMED NAME: URBAN JUICE & SODA CO LTD /WY/ DATE OF NAME CHANGE: 19990407 4 1 rdgdoc.xml FORM 4 X0306 4 2022-01-03 0001083522 JONES SODA CO JSDA 0001673527 SIRKIN CLIVE M C/O JONES SODA CO., 66 S. HANFORD ST., STE. 150 SEATTLE WA 98134 1 Stock Option (right to buy) 0.675 2022-01-03 4 A 0 37037 0 A 2023-01-03 2032-01-02 Common Stock 37037 37037 D Subject to the reporting person's continuous service with the Company through such vesting date. /s/ Joe Culp, Attorney-in-Fact for Clive M. Sirkin 2022-01-14