0001866581-22-000065.txt : 20220602
0001866581-22-000065.hdr.sgml : 20220602
20220602162907
ACCESSION NUMBER: 0001866581-22-000065
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220601
FILED AS OF DATE: 20220602
DATE AS OF CHANGE: 20220602
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Gillett Stephen
CENTRAL INDEX KEY: 0001492029
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40798
FILM NUMBER: 22991201
MAIL ADDRESS:
STREET 1: 2401 UTAH AVE S
CITY: SEATTLE
STATE: WA
ZIP: 98134
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Dutch Bros Inc.
CENTRAL INDEX KEY: 0001866581
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING & DRINKING PLACES [5810]
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
wf-form4_165420173158696.xml
FORM 4
X0306
4
2022-06-01
0
0001866581
Dutch Bros Inc.
BROS
0001492029
Gillett Stephen
C/O DUTCH BROS INC.
PO BOX 1929
GRANTS PASS
OR
97528-0163
1
0
0
0
Restricted Stock Units
2022-06-01
4
A
0
2508
0
A
Class A Common Stock
2508.0
2508
D
Each restricted stock unit represents a contingent right to receive one share of the Issuer's Class A Common Stock.
The reporting person received an award of restricted stock units, 25% of which will vest on each of September 30, 2022, December 31, 2022, March 31, 2023, and the remaining 25% will vest on the earlier of (i) June 30, 2023, and (ii) the date of the Issuer's 2023 annual stockholder meeting.
/s/ Joshua Lute, Attorney-in-Fact for Stephen Gillett
2022-06-02