0001415889-24-011076.txt : 20240417
0001415889-24-011076.hdr.sgml : 20240417
20240417203238
ACCESSION NUMBER: 0001415889-24-011076
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240417
FILED AS OF DATE: 20240417
DATE AS OF CHANGE: 20240417
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: CLARK JAMES H
CENTRAL INDEX KEY: 0001008700
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-42018
FILM NUMBER: 24852596
MAIL ADDRESS:
STREET 1: C/O MYCFO INC
STREET 2: PO BOX 10196
CITY: PALO ALTO
STATE: CA
ZIP: 94303
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Clark Jermoluk Founders Fund I LLC
CENTRAL INDEX KEY: 0002019348
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-42018
FILM NUMBER: 24852597
BUSINESS ADDRESS:
STREET 1: C/O L. CPA, EISNERAMPER ADVISORY GROUP
STREET 2: 505 S. FLAGER DRIVE, SUITE 900
CITY: WEST PALM BEACH
STATE: FL
ZIP: 33401
BUSINESS PHONE: 561-803-4623
MAIL ADDRESS:
STREET 1: C/O L. CPA, EISNERAMPER ADVISORY GROUP
STREET 2: 505 S. FLAGER DRIVE, SUITE 900
CITY: WEST PALM BEACH
STATE: FL
ZIP: 33401
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Ibotta, Inc.
CENTRAL INDEX KEY: 0001538379
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-ADVERTISING [7310]
ORGANIZATION NAME: 07 Trade & Services
IRS NUMBER: 352426358
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1801 CALIFORNIA STREET, SUITE 400
CITY: DENVER
STATE: CO
ZIP: 80202
BUSINESS PHONE: 303-593-1633
MAIL ADDRESS:
STREET 1: 1801 CALIFORNIA STREET, SUITE 400
CITY: DENVER
STATE: CO
ZIP: 80202
FORMER COMPANY:
FORMER CONFORMED NAME: Zing Enterprises, Inc.
DATE OF NAME CHANGE: 20111228
3
1
form3-04182024_120432.xml
X0206
3
2024-04-17
0
0001538379
Ibotta, Inc.
IBTA
0002019348
Clark Jermoluk Founders Fund I LLC
EISNERAMPER ADVISORY GROUP, LLC
505 S. FLAGER DR. SUITE 900
WEST PALM BEACH
FL
33401
false
false
true
false
0001008700
CLARK JAMES H
EISNERAMPER ADVISORY GROUP, LLC
505 S. FLAGER DR. SUITE 900
WEST PALM BEACH
FL
33401
0
0
1
0
Series B Preferred Stock
Common Stock
3520804
D
Series C Preferred Stock
Common Stock
1862545
D
Series C-1 Preferred Stock
Common Stock
379108
D
Each share of Series B Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock (the "IPO") and has no expiration date.
Each share of Common Stock shall be reclassified into one share of Class A Common Stock immediately prior to the completion of the IPO.
The shares are held by Clark Jermoluk Founders Fund I LLC, which is 95% owned by the JHC Family 2016 Trust (the "JHC Trust"). The JHC Trust is an entity controlled by James H. Clark.
Each share of Series C Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the IPO and has no expiration date.
Each share of Series C-1 Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the IPO and has no expiration date.
/s/ James H. Clark
2024-04-17