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