0001209191-22-039502.txt : 20220627
0001209191-22-039502.hdr.sgml : 20220627
20220627171608
ACCESSION NUMBER: 0001209191-22-039502
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220616
FILED AS OF DATE: 20220627
DATE AS OF CHANGE: 20220627
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: HAQUE PROMOD
CENTRAL INDEX KEY: 0001089744
STATE OF INCORPORATION: CA
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40263
FILM NUMBER: 221045589
MAIL ADDRESS:
STREET 1: C/O NORWEST VENTURE PARTNERS
STREET 2: 525 UNIVERSITY AVENUE, SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Crowe Jeffrey
CENTRAL INDEX KEY: 0001535261
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40263
FILM NUMBER: 221045590
MAIL ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE
STREET 2: SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NVP Associates, LLC
CENTRAL INDEX KEY: 0001545692
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40263
FILM NUMBER: 221045591
BUSINESS ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE
STREET 2: SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94301
BUSINESS PHONE: 650-321-8000
MAIL ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE
STREET 2: SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kossow Jon Erik
CENTRAL INDEX KEY: 0001726084
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40263
FILM NUMBER: 221045588
MAIL ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE, SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Norwest Venture Partners XIII, LP
CENTRAL INDEX KEY: 0001772583
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40263
FILM NUMBER: 221045592
BUSINESS ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE, SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94301
BUSINESS PHONE: (650)321-8000
MAIL ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE, SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94301
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Grove Collaborative Holdings, Inc.
CENTRAL INDEX KEY: 0001841761
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-CATALOG & MAIL-ORDER HOUSES [5961]
IRS NUMBER: 000000000
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1301 SANSOME STREET
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
BUSINESS PHONE: (800) 231-8527
MAIL ADDRESS:
STREET 1: 1301 SANSOME STREET
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
FORMER COMPANY:
FORMER CONFORMED NAME: Virgin Group Acquisition Corp. II
DATE OF NAME CHANGE: 20210122
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2022-06-16
0
0001841761
Grove Collaborative Holdings, Inc.
GROV
0001772583
Norwest Venture Partners XIII, LP
525 UNIVERSITY AVENUE, SUITE 800
PALO ALTO
CA
94301
0
0
1
0
0001545692
NVP Associates, LLC
525 UNIVERSITY AVENUE, SUITE 800
PALO ALTO
CA
94301
0
0
1
0
0001535261
Crowe Jeffrey
525 UNIVERSITY AVENUE, SUITE 800
PALO ALTO
CA
94301
0
0
1
0
0001089744
HAQUE PROMOD
525 UNIVERSITY AVENUE, SUITE 800
PALO ALTO
CA
94301
0
0
1
0
0001726084
Kossow Jon Erik
525 UNIVERSITY AVENUE, SUITE 800
PALO ALTO
CA
94301
0
0
1
0
Class A Common Stock
500100
I
By Norwest Venture Partners XIII, LP
Class B Common Stock
Class A Common Stock
15489908
I
By Norwest Venture Partners XIII, LP
The securities are directly held by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and NVP Associates, LLC ("NVP Associates") is the managing member of Genesis XIII. Genesis XIII, NVP Associates and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power over the shares held by NVP XIII. Each of Genesis XIII, NVP Associates and Messrs. Crowe, Haque and Kossow disclaims beneficial ownership of the securities held by NVP XIII except to the extent of its or his pecuniary interest therein.
Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis for no additional consideration at the Reporting Person's election and has no expiration date.
This amount includes 1,272,396 restricted shares of Class B Common Stock that will vest upon the achievement of certain earnout thresholds prior to June 16, 2032 (the "Earnout Shares") as follows: (i) 50% of the Earnout Shares automatically vest if the daily volume weighted average price ("VWAP") of the shares of Class A Common Stock is greater than or equal to $12.50 per share for any 20 trading days within any 30-trading-day period; and (ii) 50% of the Earnout Shares automatically vest if the daily VWAP of the shares of Class A Common Stock is greater than or equal to $15.00 per share for any 20 trading days within any 30-trading-day period, each subject to certain change-of-control provisions.
Norwest Venture Partners XIII, LP, By: Genesis VC Partners XIII, LLC, its general partner, By: NVP Associates, LLC, its managing member, By /s/ Matthew De Dominicis, Chief Financial Officer
2022-06-27
NVP Associates, LLC, By /s/ Matthew De Dominicis, Chief Financial Officer
2022-06-27
Jeffrey Crowe, By /s/ Matthew De Dominicis, Attorney-in-fact
2022-06-27
Promod Haque, By /s/ Matthew De Dominicis, Attorney-in-fact
2022-06-27
Jon E. Kossow, By /s/ Matthew De Dominicis, Attorney-in-fact
2022-06-27