SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
SKOK DAVID R

(Last) (First) (Middle)
C/O MATRIX PARTNERS,
101 MAIN STREET, 17TH FLOOR

(Street)
CAMBRIDGE MA 02142

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/08/2014
3. Issuer Name and Ticker or Trading Symbol
HUBSPOT INC [ HUBS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
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)
Common Stock 10,838 I By Matrix Partners VIII, L.P.(1)
Common Stock 6 I By Matrix VIII U.S. Management Co., L.L.C.(1)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: 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
Series B Convertible Preferred Stock (2) (2) Common Stock 3,014,396(3) (2) I By Matrix Partners VIII, L.P.(1)
Series C Convertible Preferred Stock (2) (2) Common Stock 1,002,104(3) (2) I By Matrix Partners VIII, L.P.(1)
Series D Convertible Preferred Stock (2) (2) Common Stock 236,207(3) (2) I By Matrix Partners VIII, L.P.(1)
Series E Convertible Preferred Stock (2) (2) Common Stock 73,046(3) (2) I By Matrix Partners VIII, L.P.(1)
Series B Convertible Preferred Stock (2) (2) Common Stock 1,661(3) (2) I By Matrix VIII U.S. Management Co., L.L.C.(1)
Series C Convertible Preferred Stock (2) (2) Common Stock 551(3) (2) I By Matrix VIII U.S. Management Co., L.L.C.(1)
Series D Convertible Preferred Stock (2) (2) Common Stock 130(3) (2) I By Matrix VIII U.S. Management Co., L.L.C.
Series E Convertible Preferred Stock (2) (2) Common Stock 40(3) (2) I By Matrix VIII U.S. Management Co., L.L.C.(1)
Explanation of Responses:
1. Mr. Skok is a Managing Member of Matrix VIII U.S. Management Co., L.L.C., which is the general partner of Matrix Partners VIII, L.P. Mr. Skok, by virtue of his management position in Matrix VIII U.S. Management Co., L.L.C., has sole voting and dispositive power with respect to these shares. Mr. Skok disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein.
2. The Series B, C, D and E Preferred Stock are each convertible at any time at the option of the holder, and will automatically convert into shares of Common Stock on a 1-for-3 basis upon the closing of the Issuer's initial public offering. The securities have no expiration date.
3. Represents the number of shares of Common Stock issuable upon conversion of the Preferred Stock on the terms specified in footnote 2.
Remarks:
Exhibit 24.1: Limited Power of Attorney
/s/ John Kelleher, attorney-in-fact 10/08/2014
** Signature of Reporting Person Date
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 5 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.