0001224922-24-000003.txt : 20240603
0001224922-24-000003.hdr.sgml : 20240603
20240603212504
ACCESSION NUMBER: 0001224922-24-000003
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240530
FILED AS OF DATE: 20240603
DATE AS OF CHANGE: 20240603
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: EFRUSY KEVIN
CENTRAL INDEX KEY: 0001224922
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40601
FILM NUMBER: 241015839
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]
ORGANIZATION NAME: 06 Technology
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_1717464296.xml
FORM 4
X0508
4
2024-05-30
0
0001845022
Couchbase, Inc.
BASE
0001224922
EFRUSY KEVIN
C/O COUCHBASE, INC.
3250 OLCOTT STREET
SANTA CLARA
CA
95054
1
0
0
0
0
Common Stock
2024-05-30
4
A
0
6494
0
A
28027
D
Common Stock
548874
I
Accel X L.P.
Common Stock
146484
I
Accel Growth Fund II Strategic Partners L.P.
Common Stock
217110
I
Accel Growth Fund Investors 2013 L.L.C.
Common Stock
41585
I
Accel X Strategic Partners L.P.
Common Stock
2022312
I
Accel Growth Fund II L.P.
Common Stock
57390
I
Accel Investors 2008 L.L.C.
Common Stock
560
I
Accel X Associates L.L.C.
Common Stock
35592
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.
Reflects distributions of (i) 423,600 shares of the Issuer's common stock, (ii) 423,600 shares of the Issuer's common stock, and (iii) 550,680 shares of the Issuer's common stock, in each case distributed by Accel X L.P. to its limited partners and general partner, which shares were further distributed, representing each such partner's pro rata interest in such shares distributed, for no consideration on December 18, 2023, January 8, 2024, and March 7, 2024, respectively, 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, 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, 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.
Reflects distributions of (i) 32,100 shares of the Issuer's common stock, (ii) 32,100 shares of the Issuer's common stock, and (iii) 41,730 shares of the Issuer's common stock, in each case distributed by Accel X Strategic Partners L.P. to its limited partners and general partner, which shares were further distributed, representing each such partner's pro rata interest in such shares distributed, for no consideration on December 18, 2023, January 8, 2024, and March 7, 2024, respectively, in accordance with the exemptions afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended.
Reflects distributions of (i) 44,300 shares of the Issuer's common stock, (ii) 44,300 shares of the Issuer's common stock, and (iii) 57,590 shares of the Issuer's common stock, in each case distributed by Accel Investors 2008 L.L.C. to its limited partners and general partner, which shares were further distributed, representing each such partner's pro rata interest in such shares distributed, for no consideration on December 18, 2023, January 8, 2024, and March 7, 2024, respectively, in accordance with the exemptions afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended.
Reflects distribution of (i) 476 shares of the Issuer's common stock by Accel X L.P. and (ii) 84 shares of the Issuer's common stock by Accel X Strategic Partners L.P., in each case distributed to A10A for no consideration on March 7, 2024, in accordance with the exemptions afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended.
Reflects distributions of (i) 7,521 shares of the Issuer's common stock, (ii) 6,396 shares of the Issuer's common stock, and (iii) 210 shares of the Issuer's common stock, in each case distributed to The Efrusy Family Trust u/a/d 10/21/2005 (the "Trust"), of which Mr. Efrusy is a Trustee, for no consideration on December 18, 2023, January 8, 2024, and March 7, 2024, respectively, in accordance with the exemptions afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended.
Shares held by the Trust. 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
2024-06-03