0001415889-22-002938.txt : 20220314 0001415889-22-002938.hdr.sgml : 20220314 20220314170054 ACCESSION NUMBER: 0001415889-22-002938 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220311 FILED AS OF DATE: 20220314 DATE AS OF CHANGE: 20220314 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Anderson Janelle Denise CENTRAL INDEX KEY: 0001899092 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41147 FILM NUMBER: 22737383 MAIL ADDRESS: STREET 1: 505 HIGHWAY 169 NORTH STREET 2: SUITE 255 CITY: PLYMOUTH STATE: MN ZIP: 55441 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Fresh Vine Wine, Inc. CENTRAL INDEX KEY: 0001880343 STANDARD INDUSTRIAL CLASSIFICATION: BEVERAGES [2080] IRS NUMBER: 834709895 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 505 HIGHWAY 169 NORTH, SUITE 255 CITY: PLYMOUTH STATE: MN ZIP: 55441 BUSINESS PHONE: 855-766-9463 MAIL ADDRESS: STREET 1: 505 HIGHWAY 169 NORTH, SUITE 255 CITY: PLYMOUTH STATE: MN ZIP: 55441 FORMER COMPANY: FORMER CONFORMED NAME: FRESH GRAPES, LLC DATE OF NAME CHANGE: 20210826 4 1 form4-03142022_020305.xml X0306 4 2022-03-11 0001880343 Fresh Vine Wine, Inc. VINE 0001899092 Anderson Janelle Denise 505 HIGHWAY 169 NORTH SUITE 255 PLYMOUTH MN 55441 true true false false CEO Common Stock 81676 D Stock Option 3.47 2022-03-11 4 A 0 427001 0 A 2032-03-11 Common Stock 427001 427001 D The options were granted pursuant to an agreement dated March 11, 2022 between the Company and the Reporting Person. Options to acquire 427,001 shares will vest in three installments of 142,334 each on 9/11/2022 and 3/11/2023, and 142,333 on 3/11/2024. The grant was approved in accordance with Rule 16b-3(d) of the Securities Exchange Act of 1934 (the "1934 Act"), and in accordance with Rule 16b-3(a) of the 1934 Act is exempt from Section 16(b) of the 1934 Act. Exhibit 24.1 Power of Attorney filed with Form 3 on December 14, 2021 and incorporated herein by reference. /s/ Elliot Savoie, Attorney-in-Fact 2022-03-11