0001209191-22-006018.txt : 20220201 0001209191-22-006018.hdr.sgml : 20220201 20220201181255 ACCESSION NUMBER: 0001209191-22-006018 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210726 FILED AS OF DATE: 20220201 DATE AS OF CHANGE: 20220201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: EFRUSY KEVIN CENTRAL INDEX KEY: 0001224922 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40601 FILM NUMBER: 22580550 MAIL ADDRESS: STREET 1: 428 UNIVERSITY AVE CITY: PALO ALTO STATE: CA ZIP: 94031 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Couchbase, Inc. CENTRAL INDEX KEY: 0001845022 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 263576987 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 3250 OLCOTT STREET CITY: SANTA CLARA STATE: CA ZIP: 95054 BUSINESS PHONE: 6504177500 MAIL ADDRESS: STREET 1: 3250 OLCOTT STREET CITY: SANTA CLARA STATE: CA ZIP: 95054 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-07-26 0 0001845022 Couchbase, Inc. BASE 0001224922 EFRUSY KEVIN 3250 OLCOTT ST. SANTA CLARA CA 95054 1 0 1 0 Common Stock 2021-07-26 4 C 0 3588629 A 3852959 I By: Accel X L.P. Common Stock 2021-07-26 4 C 0 271940 A 291963 I By: Accel X Strategic Partners L.P. Common Stock 2021-07-26 4 C 0 1682587 A 2022312 I By: Accel Growth Fund II L.P. Common Stock 2021-07-26 4 C 0 121884 A 146484 I By: Accel Growth Fund II Strategic Partners L.P. Common Stock 2021-07-26 4 C 0 180644 A 217110 I By: Accel Growth Fund Investors 2013 L.L.C. Common Stock 2021-07-26 4 C 0 375294 A 402927 I By: Accel Investors 2008 L.L.C. Series A Preferred Stock 2021-07-26 4 C 0 1636046 0.00 D Common Stock 1636046 0 I By: Accel X L.P. Series A Preferred Stock 2021-07-26 4 C 0 123978 0.00 D Common Stock 123978 0 I By: Accel X Strategic Partners L.P. Series A Preferred Stock 2021-07-26 4 C 0 171097 0.00 D Common Stock 171097 0 I By: Accel Investors 2008 L.L.C. Series B Preferred Stock 2021-07-26 4 C 0 874690 0.00 D Common Stock 874690 0 I By: Accel X L.P. Series B Preferred Stock 2021-07-26 4 C 0 66283 0.00 D Common Stock 66283 0 I By: Accel X Strategic Partners L.P. Series B Preferred Stock 2021-07-26 4 C 0 91474 0.00 D Common Stock 91474 0 I By: Accel Investors 2008 L.L.C. Series C Preferred Stock 2021-07-26 4 C 0 336658 0.00 D Common Stock 336658 0 I By: Accel X L.P. Series C Preferred Stock 2021-07-26 4 C 0 25511 0.00 D Common Stock 25511 0 I By: Accel X Strategic Partners L.P. Series C Preferred Stock 2021-07-26 4 C 0 35207 0.00 D Common Stock 35207 0 I By: Accel Investors 2008 L.L.C. Series D Preferred Stock 2021-07-26 4 C 0 279944 0.00 D Common Stock 279944 0 I By: Accel X L.P. Series D Preferred Stock 2021-07-26 4 C 0 21214 0.00 D Common Stock 21214 0 I By: Accel X Strategic Partners L.P. Series D Preferred Stock 2021-07-26 4 C 0 29276 0.00 D Common Stock 29276 0 I By: Accel Investors 2008 L.L.C. Series E Preferred Stock 2021-07-26 4 C 0 130898 0.00 D Common Stock 137809 0 I By: Accel X L.P. Series E Preferred Stock 2021-07-26 4 C 0 9919 0.00 D Common Stock 10442 0 I By: Accel X Strategic Partners L.P. Series E Preferred Stock 2021-07-26 4 C 0 1083886 0.00 D Common Stock 1141113 0 I By: Accel Growth Fund II L.P. Series E Preferred Stock 2021-07-26 4 C 0 78516 0.00 D Common Stock 82661 0 I By: Accel Growth Fund II Strategic Partners L.P. Series E Preferred Stock 2021-07-26 4 C 0 116368 0.00 D Common Stock 122512 0 I By: Accel Growth Fund Investors 2013 L.L.C. Series E Preferred Stock 2021-07-26 4 C 0 13689 0.00 D Common Stock 14411 0 I By: Accel Investors 2008 L.L.C. Series F Preferred Stock 2021-07-26 4 C 0 92672 0.00 D Common Stock 92672 0 I By: Accel X L.P. Series F Preferred Stock 2021-07-26 4 C 0 7022 0.00 D Common Stock 7022 0 I By: Accel X Strategic Partners L.P. Series F Preferred Stock 2021-07-26 4 C 0 155124 0.00 D Common Stock 155124 0 I By: Accel Growth Fund II L.P. Series F Preferred Stock 2021-07-26 4 C 0 11237 0.00 D Common Stock 11237 0 I By: Accel Growth Fund II Strategic Partners L.P. Series F Preferred Stock 2021-07-26 4 C 0 16654 0.00 D Common Stock 16654 0 I By: Accel Growth Fund Investors 2013 L.L.C. Series F Preferred Stock 2021-07-26 4 C 0 9691 0.00 D Common Stock 9691 0 I By: Accel Investors 2008 L.L.C. Series G Preferred Stock 2021-07-26 4 C 0 216371 0.00 D Common Stock 230810 0 I y: Accel X L.P. Series G Preferred Stock 2021-07-26 4 C 0 16396 0.00 D Common Stock 17490 0 I By: Accel X Strategic Partners L.P. Series G Preferred Stock 2021-07-26 4 C 0 362181 0.00 D Common Stock 386350 0 I By: Accel Growth Fund II L.P. Series G Preferred Stock 2021-07-26 4 C 0 26236 0.00 D Common Stock 27986 0 I By: Accel Growth Fund II Strategic Partners L.P. Series G Preferred Stock 2021-07-26 4 C 0 38884 0.00 D Common Stock 41478 0 I By: Accel Growth Fund Investors 2013 L.L.C. Series G Preferred Stock 2021-07-26 4 C 0 22628 0.00 D Common Stock 24138 0 I By: Accel Investors 2008 L.L.C. Immediately prior to the completion of the Issuer's initial public offering, each share of Series A Preferred Stock, Series B Preferred Stock, Series C Preferred Stock, Series D Preferred Stock and Series F Preferred Stock is convertible into shares of the Issuer's Common Stock, par value $0.00001 per share, on a one-for-one basis and has no expiration date. Immediately prior to the completion of the Issuer's initial public offering, each share of Series E Preferred Stock is convertible into shares of the Issuer's Common Stock, par value $0.00001 per share, on a 1.05279880234039-for-one basis and has no expiration date. Immediately prior to the completion of the Issuer's initial public offering, each share of Series G Preferred Stock is convertible into shares of the Issuer's Common Stock, par value $0.00001 per share, on a 1.06673317089756-for-one basis and has no expiration date. Kevin J. Efrusy is a Managing Member of Accel X Associates L.L.C., or A10A, which is the General Partner of both Accel X L.P. and Accel X Strategic Partners L.P., and has the sole voting and investment power. Andrew G. Braccia, Kevin J. Efrusy, Sameer K. Gandhi, Ping Li, Tracy L. Sedlock and Richard P. Wong are the Managing Members of Accel Investors 2008 L.L.C., and therefore share the voting and investment powers. Accel Growth Fund II Associates L.L.C., or AGF2A, is the General Partner of both Accel Growth Fund II L.P. and Accel Growth Fund II Strategic Partners L.P., and has the sole voting and investment power. Andrew G. Braccia, Sameer K. Gandhi, Ping Li, Tracy L. Sedlock, Ryan J. Sweeney and Richard P. Wong are the Managing Members of AGF2A and share such powers. Andrew G. Braccia, Sameer K. Gandhi, Ping Li, Tracy L. Sedlock, Ryan J. Sweeney and Richard P. Wong are the Managing Members of Accel Growth Fund Investors 2013 L.L.C. (continuation of FN 2): and therefore share the voting and investment powers. Each general partner or manager disclaims beneficial ownership except to the extent of their pecuniary interest therein. The address for all Accel entities listed above is 500 University Avenue, Palo Alto, California 94301. This Form 4 is being filed late due to inadvertent administrative error. /s/ Margaret Chow, by Power of Attorney for Kevin Efrusy 2022-02-01