0001209191-18-039939.txt : 20180628
0001209191-18-039939.hdr.sgml : 20180628
20180628172046
ACCESSION NUMBER: 0001209191-18-039939
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180626
FILED AS OF DATE: 20180628
DATE AS OF CHANGE: 20180628
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Horowitz Eliot
CENTRAL INDEX KEY: 0001719479
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38240
FILM NUMBER: 18926383
MAIL ADDRESS:
STREET 1: C/O MONGODB, INC.
STREET 2: 229 WEST 43RD STREET, 5TH FL
CITY: NEW YORK
STATE: NY
ZIP: 10036
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: MongoDB, Inc.
CENTRAL INDEX KEY: 0001441816
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0131
BUSINESS ADDRESS:
STREET 1: 229 W. 43RD STREET
STREET 2: 5TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
BUSINESS PHONE: 866-237-8815
MAIL ADDRESS:
STREET 1: 229 W. 43RD STREET
STREET 2: 5TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
FORMER COMPANY:
FORMER CONFORMED NAME: 10GEN INC
DATE OF NAME CHANGE: 20080801
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-06-26
0
0001441816
MongoDB, Inc.
MDB
0001719479
Horowitz Eliot
C/O MONGODB, INC.
229 WEST 43RD STREET, 5TH FLOOR
NEW YORK
NY
10036
1
1
0
0
Chief Technology Officer
Class A Common Stock
2018-06-26
4
C
0
2161
A
92161
D
Class B Common Stock
2018-06-26
4
C
0
2161
D
Class A Common Stock
2161
1502063
D
Class B Common Stock
Class A Common Stock
375000
375000
I
By Trust
Each share of Class B Common Stock is convertible at any time at the option of the reporting person into one share of Class A Common Stock and has no expiration date. The Class B Common Stock will convert automatically into Class A Common Stock on the same basis upon the earlier of: (i) any transfer, whether or not for value, except for certain "Permitted Transfers" as defined in the Issuer's restated certificate of incorporation, and (ii) at such time as the outstanding shares of Class B common stock represent less than 10% of the aggregate number of shares of the Issuer's capital stock outstanding.
These shares are held by The ERH Family 2012 Trust for the benefit of the reporting person's children. The reporting person is the trustee of the Trust. The reporting person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
/s/ Alison Haggerty, Attorney-in-Fact
2018-06-28