0001462056-23-000162.txt : 20230607 0001462056-23-000162.hdr.sgml : 20230607 20230607172954 ACCESSION NUMBER: 0001462056-23-000162 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230605 FILED AS OF DATE: 20230607 DATE AS OF CHANGE: 20230607 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: D An Evelyn CENTRAL INDEX KEY: 0001325168 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41026 FILM NUMBER: 231000000 MAIL ADDRESS: STREET 1: 1301 NE 103RD STREET CITY: MIAMI SHORES STATE: FL ZIP: 33138 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Backblaze, Inc. CENTRAL INDEX KEY: 0001462056 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 208893125 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 500 BEN FRANKLIN CT CITY: SAN MATEO STATE: CA ZIP: 94401 BUSINESS PHONE: 650.352.3738 MAIL ADDRESS: STREET 1: 500 BEN FRANKLIN CT CITY: SAN MATEO STATE: CA ZIP: 94401 4 1 wk-form4_1686173383.xml FORM 4 X0407 4 2023-06-05 0 0001462056 Backblaze, Inc. BLZE 0001325168 D An Evelyn 500 BEN FRANKLIN CT. SAN MATEO CA 94401 1 0 0 0 0 Class A Common Stock 2023-06-05 4 A 0 35211 0 A 53187 D Pursuant to the Issuer's Director Compensation Policy, the Reporting Person was granted restricted stock units ("RSUs"), which represent a contingent right to receive one share of Class A Common Stock for each RSU. The RSUs are subject to a service-based vesting requirement, which shall be satisfied on the earlier of (A) the date of the Issuer's next Annual Meeting of Stockholders, or (B) the one-year anniversary of June 5, 2023, provided that the Reporting Person remains in continuous service through such vesting date. /s/ Thomas MacMitchell - Attorney-in-Fact 2023-06-07