0001866581-24-000170.txt : 20240520 0001866581-24-000170.hdr.sgml : 20240520 20240520153924 ACCESSION NUMBER: 0001866581-24-000170 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240516 FILED AS OF DATE: 20240520 DATE AS OF CHANGE: 20240520 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Boersma Travis CENTRAL INDEX KEY: 0001883154 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40798 FILM NUMBER: 24964178 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_1716233953.xml FORM 4 X0508 4 2024-05-16 0 0001866581 Dutch Bros Inc. BROS 0001883154 Boersma Travis C/O DUTCH BROS INC. 110 SW 4TH STREET GRANTS PASS OR 97526 1 1 1 0 Executive Chairman of Board 1 Class A Common Stock 2024-05-17 4 S 0 165416 36.7877 D 1836960 I By DM Trust Aggregator, LLC Class A Common Stock 2024-05-17 4 S 0 54058 37.4093 D 1782902 I By DM Trust Aggregator, LLC Class A Common Stock 2024-05-17 4 S 0 166005 36.7864 D 1093270 I By DM Individual Aggregator, LLC Class A Common Stock 2024-05-17 4 S 0 54031 37.4077 D 1039239 I By DM Individual Aggregator, LLC Class B Common Stock 2024-05-16 4 J 0 14700075 0 D 20607740 I By DM Trust Aggregator, LLC Class B Common Stock 2024-05-16 4 J 0 8041325 0 D 14163460 I By DM Individual Aggregator, LLC Class B Common Stock 2024-05-16 4 J 0 258600 0 D 455480 I By DMI Holdco LLC As indicated by the checkbox above, this transaction was effected automatically pursuant to a Rule 10b5-1 trading plan adopted by DM Trust Aggregator, LLC on August 15, 2023. Represents the weighted average sale price. These shares were sold in multiple transactions at prices ranging from $36.2500 to $37.2400 inclusive. The reporting person undertakes to provide the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth above. Represents the weighted average sale price. These shares were sold in multiple transactions at prices ranging from $37.2500 to $37.7600 inclusive. The reporting person undertakes to provide the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth above. As indicated by the checkbox above, this transaction was effected automatically pursuant to a Rule 10b5-1 trading plan adopted by DM Individual Aggregator, LLC on August 15, 2023. Pursuant to that certain Share Surrender Agreement, dated May 16, 2024, by and among the Issuer, Dutch Mafia, LLC, DM Trust Aggregator, LLC, DM Individual Aggregator, LLC and DMI Holdco LLC (the "Share Surrender Agreement"), each of DM Trust Aggregator, LLC, DM Individual Aggregator, LLC and DMI Holdco LLC surrendered and transferred to the Issuer for no consideration 14,700,075, 8,041,325 and 258,600 shares of Class B Common Stock, respectively. Without any further action on the part of the Issuer, all shares of Class B Common Stock surrendered to the Issuer pursuant to the Share Surrender Agreement were automatically cancelled immediately following such surrender. /s/ Thomas P. Conaghan, Attorney-in-Fact for Travis Boersma 2024-05-20