0001437749-23-016100.txt : 20230530 0001437749-23-016100.hdr.sgml : 20230530 20230530160229 ACCESSION NUMBER: 0001437749-23-016100 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230525 FILED AS OF DATE: 20230530 DATE AS OF CHANGE: 20230530 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: 23976248 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: 4786 1ST AVENUE SOUTH STREET 2: SUITE D4 CITY: SEATTLE STATE: WA ZIP: 98134 BUSINESS PHONE: 206 624-3357 MAIL ADDRESS: STREET 1: 4786 1ST AVENUE SOUTH STREET 2: SUITE D4 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 X0407 4 2023-05-25 0001083522 JONES SODA CO JSDA 0001673527 SIRKIN CLIVE M 4786 1ST AVENUE SOUTH, SUITE 103 SEATTLE WA 98134 1 0 Stock Option (right to buy) 0.209 2023-05-25 4 A 0 450000 0 A 2033-05-25 Common Stock 450000 450000 D Stock Options shall vest and become exercisable into shares of the Company's common stock in accordance with the following vesting schedule: (i) 150,000 Stock Options on January 2, 2024, (ii) 150,000 Stock Options on January 2, 2025, and (iii) the remaining 150,000 Stock Options on January 2, 2026. /s/ Joe Culp, Attorney-in-Fact for Clive M. Sirkin 2023-05-30