Sec Form 4 Filing - Boersma Travis @ Dutch Bros Inc. - 2021-09-22

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Boersma Travis
2. Issuer Name and Ticker or Trading Symbol
Dutch Bros Inc. [ BROS]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director X __ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Executive Chairman of Board
(Last) (First) (Middle)
C/O DUTCH BROS INC., 110 SW 4TH STREET
3. Date of Earliest Transaction (MM/DD/YY)
09/22/2021
(Street)
GRANTS PASS, OR97526
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Class A Common Stock 11/15/2021 P 19.3603 A $ 62.01 19.3603 I By Son ( 1 )
Class A Common Stock 11/15/2021 S 19.3603 D $ 62.24 0 I By Son ( 1 )
Class A Common Stock 05/18/2022 P 107.9481 A $ 24.89 107.9481 I By Son ( 1 )
Class A Common Stock 05/27/2022 S 1.4508 D $ 37.59 ( 2 ) 106.4972 I By Son ( 1 )
Class A Common Stock 05/27/2022 P 1.4781 A $ 36.89 107.9754 I By Son ( 1 )
Class A Common Stock 09/01/2022 P 29.0477 A $ 34.43 ( 3 ) 137.0231 I By Son ( 1 )
Class A Common Stock 09/13 /2022 P 41.9693 A $ 35.74 ( 4 ) 178.9924 I By Son ( 1 )
Class A Common Stock 01/06/2023 S 100 D $ 30 78.9924 I By Son ( 1 )
Class A Common Stock 01/09/2023 S 78 D $ 31.4 0.9924 I By Son ( 1 )
Class A Common Stock 03/01/2023 P 255 A $ 32 255.9924 I By Son ( 1 )
Class A Common Stock 03/07/2023 P 1.9831 A $ 33.73 257.9755 I By Son ( 1 )
Class A Common Stock 03/27/2023 S 25.4496 D $ 29.44 232.5259 I By Son ( 1 )
Class A Common Stock 03/27/2023 P 25.4331 A $ 29.45 257.959 I By Son ( 1 )
Class A Common Stock 04/14/2023 S 128.972 D $ 32.1 128.987 I By Son ( 1 )
Class A Common Stock 05/10/2023 P 130.3816 A $ 29.8 ( 5 ) 259.3686 I By Son ( 1 )
Class A Common Stock 08/03/2023 S 136.1934 D $ 29.36 123.1752 I By Son ( 1 )
Class A Common Stock 08/08/2023 S 27.3423 D $ 27.43 95.8329 I By Son ( 1 )
Class A Common Stock 08/08/2023 P 2.4696 A $ 27.51 98.3025 I By Son ( 1 )
Class A Common Stock 08/08/2023 P 10.8456 A $ 27.66 109.1482 I By Son ( 1 )
Class A Common Stock 08/09/2023 S 109.1482 D $ 30.72 ( 6 ) 0 I By Son ( 1 )
Class A Common Stock 15,610 I By DM Trust Aggregator, LLC
Class A Common Stock 9,817 I By DM Individual Aggregator, LLC
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Call Option (Right to Buy) $ 60 09/22/2021 P 1 09/22/2021 10/15/2021 Class A Common Stock 100 $ 440 1 I By Son ( 1 )
Call Option (Right to Buy) $ 60 09/22/2021 S 1 09/22/2021 10/15/2021 Class A Common Stock 100 $ 399.98 0 I By Son ( 1 )
Call Option (Right to Buy) $ 40 10/05/2021 P 1 10/05/2021 10/15/2021 Class A Common Stock 100 $ 430 1 I By Son ( 1 )
Call Option (Right to Buy) $ 40 10/07/2021 S 1 10/05/2021 10/15/2021 Class A Common Stock 100 $ 479.98 0 I By Son ( 1 )
Put Option (Right to Sell) $ 60 10/19/2021 P 1 10/19/2021 11/19/2021 Class A Common Stock 100 $ 500 1 I By Son ( 1 )
Put Option (Right to Sell) $ 60 10/21/2021 S 1 10/19/2021 11/19/2021 Class A Common Stock 100 $ 569.98 0 I By Son ( 1 )
Put Option (Right to Sell) $ 41 02/21/2023 P 2 02/21/2023 02/24/2023 Class A Common Stock 200 $ 401 2 I By Son ( 1 )
Put Option (Right to Sell) $ 41 02/21/2023 P 4 02/21/2023 02/24/2023 Class A Common Stock 400 $ 400 6 I By Son ( 1 )
Put Option (Right to Sell) $ 41 02/21/2023 P 1 02/21/2023 03/03/2024 Class A Common Stock 100 $ 420 1 I By Son ( 1 )
Put Option (Right to Sell) $ 41 02/24/2023 S 4 02/21/2023 02/24/2023 Class A Common Stock 400 $ 789.98 2 I By Son ( 1 )
Put Option (Right to Sell) $ 41 02/24/2023 S 2 02/21/2023 02/24/2023 Class A Common Stock 200 $ 809.98 0 I By Son ( 1 )
Put Option (Right to Sell) $ 41 03/01/2023 S 1 02/21/2023 03/03/2024 Class A Common Stock 100 $ 819.98 0 I By Son ( 1 )
Put Option (Right to Sell) $ 33 05/09/2023 P 5 05/09/2023 05/12/2023 Class A Common Stock 500 $ 210 5 I By Son ( 1 )
Put Option (Right to Sell) $ 33 05/09/2023 S 5 05/09/2023 05/12/2023 Class A Common Stock 500 $ 200 0 I By Son ( 1 )
Put Option (Right to Sell) $ 33 05/09/2023 P 1 05/09/2023 05/12/2023 Class A Common Stock 100 $ 205 1 I By Son ( 1 )
Put Option (Right to Sell) $ 33 05/10/2023 S 1 05/09/2023 05/12/2023 Class A Common Stock 100 $ 299.98 0 I By Son
Call Option (Right to Buy) $ 26 08/08/2023 P 3 08/08/2023 08/11/2023 Class A Common Stock 300 $ 230 3 I By Son ( 1 )
Call Option (Right to Buy) $ 26 08/08/2023 S 1 08/08/2023 08/11/2023 Class A Common Stock 100 $ 239.98 2 I By Son ( 1 )
Call Option (Right to Buy) $ 26 08/09/2023 S 2 08/08/2023 08/11/2023 Class A Common Stock 200 $ 549.99 0 I By Son ( 1 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Boersma Travis
C/O DUTCH BROS INC.
110 SW 4TH STREET
GRANTS PASS, OR97526
X X Executive Chairman of Board
Signatures
By Travis Boersma 08/29/2023
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Pursuant to Section 16 reporting requirements, the Form 4 reflects purchases and sales of the Issuer's Class A common stock and derivative securities that were made by the Reporting Person's adult son. The amount of profit realized by the applicable short-swing transactions is approximately $8,500 and has been paid to the Issuer, as required. The Reporting Person was recently notified of the transactions by his son, resulting in today's filing. This report shall not be deemed an admission by the Reporting Person that he is the beneficial owner of any of the securities traded by his adult son, other than for purposes of Section 16.
( 2 )Represents weighted average sales price. The shares were sold at prices ranging from $37.56 to $37.60. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price.
( 3 )Represents weighted average purchase price. The shares were sold at prices ranging from $34.39 to $34.43. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares purchased at each separate price.
( 4 )Represents weighted average purchase price. The shares were sold at prices ranging from $35.39 to $35.92. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares purchased at each separate price.
( 5 )Represents weighted average purchase price. The shares were sold at prices ranging from $29.76 to $29.80. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares purchased at each separate price.
( 6 )Represents weighted average sales price. The shares were sold at prices ranging from $30.72 to $30.78. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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