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