0001209191-23-059604.txt : 20231222 0001209191-23-059604.hdr.sgml : 20231222 20231222172038 ACCESSION NUMBER: 0001209191-23-059604 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231220 FILED AS OF DATE: 20231222 DATE AS OF CHANGE: 20231222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ford Todd R CENTRAL INDEX KEY: 0001324478 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41121 FILM NUMBER: 231510852 MAIL ADDRESS: STREET 1: 3457 BRYANT STREET CITY: PALO ALTO STATE: CA ZIP: 94306 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HashiCorp, Inc. CENTRAL INDEX KEY: 0001720671 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING SERVICES [7371] ORGANIZATION NAME: 06 Technology IRS NUMBER: 320410665 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 101 2ND STREET, SUITE 700 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: 415-301-3227 MAIL ADDRESS: STREET 1: 101 2ND STREET, SUITE 700 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 4 1 doc4.xml FORM 4 SUBMISSION X0508 4 2023-12-20 0 0001720671 HashiCorp, Inc. HCP 0001324478 Ford Todd R C/O HASHICORP, INC. 101 SECOND STREET, SUITE 700 SAN FRANCISCO CA 94105 1 0 0 0 0 Class A Common Stock 2023-12-20 4 M 0 645 A 47043 D Class A Common Stock 2023-12-21 4 C 0 6250 A 53293 D Restricted Stock Units 2023-12-20 4 M 0 645 0.00 D Class A Common Stock 645 0 D Restricted Stock Units 2023-12-20 4 M 0 6250 0.00 D Class B Common Stock 6250 6250 D Class B Common Stock 2023-12-20 4 M 0 6250 0.00 A Class A Common Stock 6250 56250 D Class B Common Stock 2023-12-21 4 C 0 6250 0.00 D Class A Common Stock 6250 50000 D Each restricted stock unit, or RSU, represents a contingent right to receive one share of Issuer Class A Common Stock. Each share of Class B Common Stock is convertible into one share of Class A Common Stock at the option of the holder and has no expiration date. The RSUs vested on December 20, 2023. Each RSU represents a contingent right to receive one share of Issuer Class B Common Stock. The remaining RSUs vest on March 20, 2024. /s/ Paul Warenski, by power of attorney 2023-12-22