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