0001866581-24-000166.txt : 20240515 0001866581-24-000166.hdr.sgml : 20240515 20240515121300 ACCESSION NUMBER: 0001866581-24-000166 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240514 FILED AS OF DATE: 20240515 DATE AS OF CHANGE: 20240515 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Davis Thomas James CENTRAL INDEX KEY: 0001884188 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40798 FILM NUMBER: 24948594 MAIL ADDRESS: STREET 1: C/O DUTCH BROS INC. STREET 2: PO BOX 1929 CITY: GRANTS PASS STATE: OR ZIP: 97528 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Dutch Bros Inc. CENTRAL INDEX KEY: 0001866581 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING & DRINKING PLACES [5810] ORGANIZATION NAME: 07 Trade & Services 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: (541) 955-4700 MAIL ADDRESS: STREET 1: PO BOX 1929 CITY: GRANTS PASS STATE: OR ZIP: 97528-0163 4 1 wk-form4_1715789571.xml FORM 4 X0508 4 2024-05-14 0 0001866581 Dutch Bros Inc. BROS 0001884188 Davis Thomas James C/O DUTCH BROS INC. PO BOX 1929 GRANTS PASS OR 97528-0163 1 0 0 0 0 Class A Common Stock 2024-05-14 4 M 0 938 0 A 9293 D Restricted Stock Units 2024-05-14 4 M 0 938 0 D Class A Common Stock 938 0 D Restricted Stock Units 2024-05-14 4 A 0 3049 0 A Class A Common Stock 3049 3049 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 vested on each of September 30, 2023, December 31, 2023, March 31, 2024, and the date of the Issuer's 2024 annual stockholder meeting, which occurred on May 14, 2024. The reporting person received an award of restricted stock units, 25% of which will vest on each of September 30, 2024, December 31, 2024, March 31, 2025 and the remaining 25% will vest on the earlier of (i) June 30, 2025, and (ii) the date of the Issuer's 2025 annual stockholder meeting. /s/ Joshua Lute, Attorney-in-Fact for Thomas J Davis 2024-05-15