0000899243-21-045146.txt : 20211117 0000899243-21-045146.hdr.sgml : 20211117 20211117192902 ACCESSION NUMBER: 0000899243-21-045146 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211115 FILED AS OF DATE: 20211117 DATE AS OF CHANGE: 20211117 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FOGELSONG NORMAN A CENTRAL INDEX KEY: 0001140932 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211422103 MAIL ADDRESS: STREET 1: C/O IVP STREET 2: 3000 SAND HILL ROAD, 2-250 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Phelps Dennis B CENTRAL INDEX KEY: 0001299965 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211422099 MAIL ADDRESS: STREET 1: 3000 SAND HILL ROAD STREET 2: 2-250 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Harrick Stephen J CENTRAL INDEX KEY: 0001299975 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211422100 MAIL ADDRESS: STREET 1: 3000 SAND HILL ROAD STREET 2: 2-250 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chaffee Todd C CENTRAL INDEX KEY: 0001300134 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211422105 MAIL ADDRESS: STREET 1: 3000 SAND HILL ROAD STREET 2: 2-250 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Miller J Sanford CENTRAL INDEX KEY: 0001359524 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211422101 MAIL ADDRESS: STREET 1: 3000 SAND HILL ROAD STREET 2: BUILDING 2, SUITE 250 CITY: MENLO PARK STATE: CA ZIP: 94025 FORMER NAME: FORMER CONFORMED NAME: Miller J Sanford (Sandy) DATE OF NAME CHANGE: 20060414 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dash Somesh CENTRAL INDEX KEY: 0001843938 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211422104 MAIL ADDRESS: STREET 1: 3000 SAND HILL ROAD STREET 2: BUILDING 2, SUITE 250 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Institutional Venture Partners XV, L.P. CENTRAL INDEX KEY: 0001640274 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211422106 BUSINESS ADDRESS: STREET 1: 3000 SAND HILL ROAD STREET 2: BUILDING 2, SUITE 250 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650 854 0132 MAIL ADDRESS: STREET 1: 3000 SAND HILL ROAD STREET 2: BUILDING 2, SUITE 250 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Institutional Venture Management XV, LLC CENTRAL INDEX KEY: 0001640275 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211422108 BUSINESS ADDRESS: STREET 1: 3000 SAND HILL ROAD STREET 2: BUILDING 2, SUITE 250 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650 854 0132 MAIL ADDRESS: STREET 1: 3000 SAND HILL ROAD STREET 2: BUILDING 2, SUITE 250 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Institutional Venture Partners XV Executive Fund, L.P. CENTRAL INDEX KEY: 0001661321 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211422107 BUSINESS ADDRESS: STREET 1: 3000 SAND HILL ROAD STREET 2: BUILDING 2, SUITE 250 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650 854 0132 MAIL ADDRESS: STREET 1: 3000 SAND HILL ROAD STREET 2: BUILDING 2, SUITE 250 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Maltz Jules A. CENTRAL INDEX KEY: 0001553254 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211422102 MAIL ADDRESS: STREET 1: 3000 SAND HILL ROAD STREET 2: BUILDING 2, SUITE 250 CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lulu's Fashion Lounge Holdings, Inc. CENTRAL INDEX KEY: 0001780201 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-CATALOG & MAIL-ORDER HOUSES [5961] IRS NUMBER: 208442468 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 195 HUMBOLDT AVENUE CITY: CHICO STATE: CA ZIP: 95928 BUSINESS PHONE: 530-343-3545 MAIL ADDRESS: STREET 1: 195 HUMBOLDT AVENUE CITY: CHICO STATE: CA ZIP: 95928 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-11-15 0 0001780201 Lulu's Fashion Lounge Holdings, Inc. LVLU 0001640275 Institutional Venture Management XV, LLC 3000 SAND HILL ROAD BLDG 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001661321 Institutional Venture Partners XV Executive Fund, L.P. 300 SAND HILL ROAD, BLDG 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001640274 Institutional Venture Partners XV, L.P. 300 SAND HILL ROAD, BLDG 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001300134 Chaffee Todd C 300 SAND HILL ROAD, BLDG 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001843938 Dash Somesh 3000 SAND HILL ROAD, BLDG. 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001140932 FOGELSONG NORMAN A 300 SAND HILL ROAD, BLDG 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001299975 Harrick Stephen J 300 SAND HILL ROAD, BLDG 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001553254 Maltz Jules A. 300 SAND HILL ROAD, BLDG 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001359524 Miller J Sanford 300 SAND HILL ROAD, BLDG 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001299965 Phelps Dennis B 300 SAND HILL ROAD, BLDG 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 Common Stock 2021-11-15 4 C 0 3730160 A 3730160 I Directly held by Institutional Venture Partners XV, L.P. Common Stock 2021-11-15 4 C 0 19843 A 19843 I Directly held by Institutional Venture Partners XV Executive Fund, L.P. Common Stock 2021-11-15 4 C 0 3749997 A 3749997 I Directly held by Institutional Venture Partners XVI, L.P. Series B Preferred Stock 2021-11-15 4 J 0 207232 D 0 I Directly held by Institutional Venture Partners XV, L.P. Series B Preferred Stock 2021-11-15 4 J 0 1102 D 0 I Directly held by Institutional Venture Partners XV Executive Fund, L.P. Series B Preferred Stock 2021-11-15 4 J 0 208383 D 0 I Directly held by Institutional Venture Partners XVI, L.P. Series A Preferred Stock 2021-11-15 4 C 0 778269 0.00 D Common Stock 3730160 0 I Directly held by Institutional Venture Partners XV, L.P. Series A Preferred Stock 2021-11-15 4 C 0 4140 0.00 D Common Stock 19843 0 I Directly held by Institutional Venture Partners XV Executive Fund, L.P. Series A Preferred Stock 2021-11-15 4 C 0 782408 0.00 D Common Stock 3749997 0 I Directly held by Institutional Venture Partners XVI, L.P. Each share of Series A Preferred Stock automatically converted into shares of Common Stock upon the closing of the Issuer's initial public offering (the "IPO") for no additional consideration, on a 1:4.79289 basis, and had no expiration date. Institutional Venture Management XV, LLC ("IVM XV") is the general partner of Institutional Venture Partners XV, L.P. ("IVP XV"). Todd C. Chaffee, Somesh Dash, Norman A. Fogelsong, Stephen J. Harrick, Jules A. Maltz, J. Sanford Miller and Dennis B. Phelps (collectively, the "Managing Directors") and Eric Liaw are the managing directors of IVM XV and may be deemed to share voting and dispositive power over the shares held by IVP XV. Each of IVM XV and the Managing Directors disclaims beneficial ownership of these securities, except to the extent of its or his respective proportionate pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports. IVM XV is the general partner of Institutional Venture Partners XV Executive Fund, L.P. ("IVP XV-EF"). The Managing Directors and Eric Liaw are the managing directors of IVM XV and may be deemed to share voting and dispositive power over the shares held by IVP XV-EF. Each of IVM XV and the Managing Directors disclaims beneficial ownership of these securities, except to the extent of its or his respective proportionate pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports. Institutional Venture Management XVI, LLC ("IVM XVI") is the general partner of Institutional Venture Partners XVI, L.P. ("IVP XVI"). The Managing Directors and Eric Liaw are the managing directors of IVM XVI and may be deemed to share voting and dispositive power over the shares held by IVP XVI. Each of IVM XVI and the Managing Directors disclaims beneficial ownership of these securities, except to the extent of its or his respective proportionate pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports. The shares of Series B Preferred Stock were redeemed by the Issuer and extinguished for cash consideration upon closing of the IPO and had no expiration date. 1 of 2: The number of joint filers exceeds the EDGAR maximum of 10 joint filers per Form. This Form 4 is being filed in conjunction with a Form 4 being filed by Institutional Venture Management XVI, LLC. /s/ Crystal Landsem, Attorney-in-Fact 2021-11-17