0001209191-23-019075.txt : 20230315 0001209191-23-019075.hdr.sgml : 20230315 20230315205327 ACCESSION NUMBER: 0001209191-23-019075 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230313 FILED AS OF DATE: 20230315 DATE AS OF CHANGE: 20230315 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: 23736865 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 2023-03-13 0 0001845022 Couchbase, Inc. BASE 0001224922 EFRUSY KEVIN 3250 OLCOTT ST. SANTA CLARA CA 95054 1 0 1 0 Common Stock 2023-03-13 4 J 0 847205 0.00 D 3005754 I By: Accel X L.P. Common Stock 2023-03-13 4 J 0 64198 0.00 D 227765 I By: Accel X Strategic Partners L.P. Common Stock 2023-03-13 4 J 0 88597 0.00 D 314330 I By: Accel Investors 2008 L.L.C. Common Stock 2023-03-13 4 J 0 13364 0.00 A 13364 I By: The Efrusy Family Trust u/a/d 10/21/2005 Common Stock 2022312 I By: Accel Growth Fund II L.P. Common Stock 146484 I By: Accel Growth Fund II Strategic Partners L.P. Common Stock 217110 I By: Accel Growth Fund Investors 2013 L.L.C. Common Stock 11659 D On March 13, 2023, Accel X LP distributed, for no consideration, 847,205 shares of Common Stock of the Issuer (the "Accel X LP Shares") to its limited partners and general partner, which shares were further distributed, representing each such partner's pro rata interest in such Accel X LP Shares. All of the aforementioned distributions were made in accordance with the exemptions afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended. Accel X Associates L.L.C. ("A10A") 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 A10A and 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 Accel Growth Fund Investors 2013 L.L.C. and share such powers. Each person 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. On March 13, 2023, Accel X Strategic Partners L.P. ("A10SP") distributed, for no consideration, 64,198 shares of Common Stock of the Issuer (the "A10SP Shares") to its limited partners and general partner, which shares were further distributed, representing each such partner's pro rata interest in such A10SP Shares. All of the aforementioned distributions were made in accordance with the exemptions afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended. On March 13, 2023, Accel Investors 2008 L.L.C. ("AI08") distributed for no consideration 88,597 shares of Common Stock of the Issuer (the "AI08 Shares") to its limited partners, representing each such partner's pro rata interest in such AI08 Shares. All of the aforementioned distributions were made in accordance with the exceptions afforded by Rules 16a-13 and 16a-9 of the Securities and Exchange Act of 1934, as amended. Reflects shares of Common Stock of the Issuer as distributed by Accel Investors 2008 L.L.C. and Accel X Associates L.L.C., for no consideration, to the Trust. Shares held by The Efrusy Family Trust u/a/d 10/21/2005 (the "Trust"), of which Mr. Efrusy is a Trustee. The Reporting Person disclaims beneficial ownership over the securities reported herein except to the extent of his pecuniary interest therein, if any, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended. Represents restricted stock units ("RSUs") of the Issuer. Each unit represents a contingent right to receive one share of the Issuer's common stock upon vesting. One hundred percent (100%) of the RSUs will, subject to the Reporting Person's continued service with the Issuer through such vesting date, vest on the earlier of (i) the one-year anniversary of the date the annual award is granted or (ii) the day prior to the date of the Annual Meeting next following the date the annual award is granted. /s/ Margaret Chow, by Power of Attorney for Kevin Efrusy 2023-03-15