Initial Statement of Beneficial Ownership (3)
September 22 2021 - 3:45PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
NORTHWOOD VENTURES LLC |
2. Date of Event Requiring Statement (MM/DD/YYYY)
7/21/2021
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3. Issuer Name and Ticker or Trading Symbol
Zevia PBC [ZVIA]
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(Last)
(First)
(Middle)
11450 DIXIE HIGHWAY, SUITE 101 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director ___X___ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Street)
HOBE SOUND, FL 33455
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Class B Common Stock (1)(2) | 4891652 | D | |
Class B Common Stock (1)(3) | 863232 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Class B Common Stock (3) | (4) | (4) | Class A Common Stock | 4891652 | (4) | D | |
Class B Units (3) | (4) | (4) | Class A Common Stock | 863232 | (4) | D | |
Explanation of Responses: |
(1) | This Form 3 is filed jointly by Northwood Ventures LLC ("Ventures") and Northwood Capital Partners LLC ("CP"). Ventures and CP may be deemed to be members of a "group". |
(2) | Information for Ventures. |
(3) | Information for CP. |
(4) | The Class B Units of Zevia LLC are exchangeable, at the holder's option, on a one-for-one basis into shares of Class A Common Stock of the Issuer, or, at the Issuer's election, cash. Upon exchange of a Class B Unit (or redemption for cash), the corresponding share of Class B Common Stock will be automatically cancelled. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
NORTHWOOD VENTURES LLC 11450 DIXIE HIGHWAY, SUITE 101 HOBE SOUND, FL 33455 |
| X |
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Signatures
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/s/ Peter G. Schiff, Managing Partner | | 9/22/2021 |
**Signature of Reporting Person | Date |
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