0000899243-21-030376.txt : 20210728
0000899243-21-030376.hdr.sgml : 20210728
20210728171333
ACCESSION NUMBER: 0000899243-21-030376
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210726
FILED AS OF DATE: 20210728
DATE AS OF CHANGE: 20210728
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Margolis Harry
CENTRAL INDEX KEY: 0001871729
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40630
FILM NUMBER: 211123593
MAIL ADDRESS:
STREET 1: 15821 VENTURA BLVD., SUITE 145
CITY: ENCINO
STATE: CA
ZIP: 91436
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Zevia PBC
CENTRAL INDEX KEY: 0001854139
STANDARD INDUSTRIAL CLASSIFICATION: BOTTLED & CANNED SOFT DRINKS CARBONATED WATERS [2086]
IRS NUMBER: 862862492
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 15821 VENTURA BLVD.
STREET 2: SUITE 145
CITY: ENCINO
STATE: CA
ZIP: 91436
BUSINESS PHONE: (310) 202-7000
MAIL ADDRESS:
STREET 1: 15821 VENTURA BLVD.
STREET 2: SUITE 145
CITY: ENCINO
STATE: CA
ZIP: 91436
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-07-26
0
0001854139
Zevia PBC
ZVIA
0001871729
Margolis Harry
C/O ZEVIA PBC
15821 VENTURA BLVD., SUITE 145
ENCINO
CA
91436
0
1
0
0
Chief Operating Officer
Stock Option (Right to Buy)
0.01
2021-07-26
4
D
0
4920
13.045
D
2028-12-31
Class A Common Stock
4920
135672
I
By Margolis Family Trust
Represents 4,920 vested options cancelled and cashed-out by mutual agreement of the Reporting Person and the Issuer. The Reporting Person received $13.045 per stock option and $64,181.40 total as consideration for the cancellation.
/s/ Lorna R. Simms, Attorney-in-Fact for Harry Margolis
2021-07-28