0001567619-21-018261.txt : 20211013 0001567619-21-018261.hdr.sgml : 20211013 20211013162307 ACCESSION NUMBER: 0001567619-21-018261 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211011 FILED AS OF DATE: 20211013 DATE AS OF CHANGE: 20211013 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Casey Ted CENTRAL INDEX KEY: 0001856959 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38785 FILM NUMBER: 211321426 MAIL ADDRESS: STREET 1: 5801 TENNYSON PKWY SUITE 275 CITY: PLANO STATE: TX ZIP: 75024 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: STRYVE FOODS, INC. CENTRAL INDEX KEY: 0001691936 STANDARD INDUSTRIAL CLASSIFICATION: FOOD & KINDRED PRODUCTS [2000] IRS NUMBER: 871760117 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5801 TENNYSON PARKWAY STREET 2: SUITE 275 CITY: PLANO STATE: TX ZIP: 75024 BUSINESS PHONE: 646-565-3861 MAIL ADDRESS: STREET 1: 5801 TENNYSON PARKWAY STREET 2: SUITE 275 CITY: PLANO STATE: TX ZIP: 75024 FORMER COMPANY: FORMER CONFORMED NAME: Andina Acquisition Corp. III DATE OF NAME CHANGE: 20161208 4 1 doc1.xml FORM 4 X0306 4 2021-10-11 0 0001691936 STRYVE FOODS, INC. SNAX 0001856959 Casey Ted C/O STRYVE FOODS, INC. 5801 TENNYSON PARKWAY, SUITE 275 PLANO TX 75024 1 0 0 0 Class A Common Stock 2021-10-11 4 A 0 8250 0 A 134551 D Class V Common Stock 1491314 I See Footnote Class A Common Stock 128306 I See Footnote Class B Units Class A Common Stock 1419314 1419314 I See Footnote Award of restricted stock under the Stryve Foods, Inc. 2021 Omnibus Incentive Plan. 4,125 shares vest immediately for past service and the remainder of the shares vesting in full on December 31, 2021, subject to continued service. All shares of Class V Common Stock and Class B Units are beneficially owned as a member of Stryve Foods Holdings, LLC. One-half of the securities are owned by the TRC GST TRFBO Trinity Jennifer Wommack Casey BTD 09302011 and the other half are owned by TRC GST TRFBO Avery Maryanna Wommack Casey BTD 09302011. Thomas Farrell Casey is the trustee and control person of, with voting and dispositive power over the securities held by, such trusts. The reporting person disclaims beneficial ownership of the securities owned by the trusts. Subject to the terms of an Exchange Agreement with Stryve Foods, Inc. ("Stryve"), a set of one Class B Unit and one share of Class V Common Stock is exchangeable for one share of Class A Common Stock of Stryve after the expiration of a lock-up applicable to such securities. The Class V Common Stock provides the holder with voting rights, but not economic rights, with respect to Stryve. /s/ Ted Casey by John J. Wolfel, Attorney-in-Fact 2021-10-13