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