0001437749-22-013472.txt : 20220524 0001437749-22-013472.hdr.sgml : 20220524 20220524211310 ACCESSION NUMBER: 0001437749-22-013472 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220516 FILED AS OF DATE: 20220524 DATE AS OF CHANGE: 20220524 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bronstein Chad CENTRAL INDEX KEY: 0001914469 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28820 FILM NUMBER: 22958749 MAIL ADDRESS: STREET 1: C/O JONES SODA CO. STREET 2: 66 S. HANFORD STREET, STE 150 CITY: SEATTLE STATE: WA ZIP: 98134 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 2022-05-16 0001083522 JONES SODA CO JSDA 0001914469 Bronstein Chad C/O JONES SODA CO., 66 S. HANFORD ST., STE. 150 SEATTLE WA 98134 1 Common Stock 2022-05-16 4 C 0 200740 0.50 A 200740 D Convertible Debentures 0.50 2022-05-16 4 C 0 100000 D 2023-02-09 Common Stock 100000 0 D Warrants 0.625 2022-05-16 4 C 0 200740 A 2022-05-16 2024-05-16 Common Stock 200740 200740 D Represents conversion of $100,000 in aggregate principal amount (plus accrued and unpaid interest) of unsecured 3% convertible debenture acquired by the reporting person on February 9, 2022, and reported on a Form 3/A filed with the Securities and Exchange Commission on May 23, 2022. /s/ Joe Culp, Attorney-In-Fact for Chad Bronstein 2022-05-24