0001224922-23-000002.txt : 20230605
0001224922-23-000002.hdr.sgml : 20230605
20230605175359
ACCESSION NUMBER: 0001224922-23-000002
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230601
FILED AS OF DATE: 20230605
DATE AS OF CHANGE: 20230605
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: 23994135
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
wk-form4_1686002030.xml
FORM 4
X0407
4
2023-06-01
0
0001845022
Couchbase, Inc.
BASE
0001224922
EFRUSY KEVIN
C/O COUCHBASE, INC.
3250 OLCOTT STREET
SANTA CLARA
CA
95054
1
0
1
0
0
Common Stock
2023-06-01
4
A
0
9874
0
A
21533
D
Common Stock
314330
I
Accel Investors 2008 L.L.C.
Common Stock
2022312
I
Accel Growth Fund II L.P.
Common Stock
227765
I
Accel X Strategic Partners L.P.
Common Stock
217110
I
Accel Growth Fund Investors 2013 L.L.C.
Common Stock
146484
I
Accel Growth Fund II Strategic Partners L.P.
Common Stock
3005754
I
Accel X L.P.
Common Stock
13364
I
The Efrusy Family Trust u/a/d 10/21/2005
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.
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.
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.
/s/ Margaret Chow, by Power of Attorney for Kevin Efrusy
2023-06-05