0001224922-22-000002.txt : 20220627
0001224922-22-000002.hdr.sgml : 20220627
20220627165910
ACCESSION NUMBER: 0001224922-22-000002
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220623
FILED AS OF DATE: 20220627
DATE AS OF CHANGE: 20220627
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: 221045386
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
wf-form4_165636352497003.xml
FORM 4
X0306
4
2022-06-23
0
0001845022
Couchbase, Inc.
BASE
0001224922
EFRUSY KEVIN
C/O COUCHBASE, INC.
3250 OLCOTT STREET
SANTA CLARA
CA
95054
1
0
0
0
Common Stock
2022-06-23
4
A
0
11659
0
A
11659
D
Common Stock
2022312
I
Accel Growth Fund II L.P.
Common Stock
3852959
I
Accel X L.P.
Common Stock
217110
I
Accel Growth Fund Investors 2013 L.L.C.
Common Stock
402927
I
Accel Investors 2008 L.L.C.
Common Stock
146484
I
Accel Growth Fund II Strategic Partners L.P.
Common Stock
291963
I
Accel X Strategic Partners L.P.
This represents an award of restricted stock units to the Issuer's non-employee director. Each unit represents a contingent right to receive one share of the Issuer's common stock upon vesting. One hundred percent (100%) of the restricted stock units 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.
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.
/s/ Margaret Chow, by Power of Attorney for Kevin Efrusy
2022-06-27