0001104659-17-044115.txt : 20170707
0001104659-17-044115.hdr.sgml : 20170707
20170707180443
ACCESSION NUMBER: 0001104659-17-044115
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170705
FILED AS OF DATE: 20170707
DATE AS OF CHANGE: 20170707
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Blue Apron Holdings, Inc.
CENTRAL INDEX KEY: 0001701114
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-CATALOG & MAIL-ORDER HOUSES [5961]
IRS NUMBER: 814777373
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 5 CROSBY STREET
CITY: NEW YORK
STATE: NY
ZIP: 10013
BUSINESS PHONE: 347-719-4312
MAIL ADDRESS:
STREET 1: 5 CROSBY STREET
CITY: NEW YORK
STATE: NY
ZIP: 10013
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: First Round Capital IV, L.P.
CENTRAL INDEX KEY: 0001547069
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38134
FILM NUMBER: 17955998
BUSINESS ADDRESS:
STREET 1: 4040 LOCUST STREET
CITY: PHILADELPHIA
STATE: PA
ZIP: 19104
BUSINESS PHONE: 610-834-1461
MAIL ADDRESS:
STREET 1: 4040 LOCUST STREET
CITY: PHILADELPHIA
STATE: PA
ZIP: 19104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kopelman Joshua
CENTRAL INDEX KEY: 0001512421
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38134
FILM NUMBER: 17956000
MAIL ADDRESS:
STREET 1: 4040 LOCUST STREET
CITY: PHILADELPHIA
STATE: PA
ZIP: 19104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Hayes Robert
CENTRAL INDEX KEY: 0001710113
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38134
FILM NUMBER: 17956001
MAIL ADDRESS:
STREET 1: 4040 LOCUST STREET
CITY: PHILADELPHIA
STATE: PA
ZIP: 19104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Fralic Christopher
CENTRAL INDEX KEY: 0001701579
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38134
FILM NUMBER: 17956002
MAIL ADDRESS:
STREET 1: 4040 LOCUST STREET
CITY: PHILADELPHIA
STATE: PA
ZIP: 19104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Barnes Phineas
CENTRAL INDEX KEY: 0001710157
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38134
FILM NUMBER: 17956003
MAIL ADDRESS:
STREET 1: 4040 LOCUST STREET
CITY: PHILADELPHIA
STATE: PA
ZIP: 19104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: First Round Capital IV Partners Fund, L.P.
CENTRAL INDEX KEY: 0001547073
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38134
FILM NUMBER: 17956004
BUSINESS ADDRESS:
STREET 1: 4040 LOCUST STREET
CITY: PHILADELPHIA
STATE: PA
ZIP: 19104
BUSINESS PHONE: 610-834-1461
MAIL ADDRESS:
STREET 1: 4040 LOCUST STREET
CITY: PHILADELPHIA
STATE: PA
ZIP: 19104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: First Round Capital Management IV, LLC
CENTRAL INDEX KEY: 0001710037
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38134
FILM NUMBER: 17956005
BUSINESS ADDRESS:
STREET 1: 4040 LOCUST STREET
CITY: PHILADELPHIA
STATE: PA
ZIP: 19104
BUSINESS PHONE: (610) 834-1461
MAIL ADDRESS:
STREET 1: 4040 LOCUST STREET
CITY: PHILADELPHIA
STATE: PA
ZIP: 19104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Trenchard William
CENTRAL INDEX KEY: 0001710102
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38134
FILM NUMBER: 17955999
MAIL ADDRESS:
STREET 1: 4040 LOCUST STREET
CITY: PHILADELPHIA
STATE: PA
ZIP: 19104
4
1
a4.xml
4
X0306
4
2017-07-05
0
0001701114
Blue Apron Holdings, Inc.
APRN
0001547069
First Round Capital IV, L.P.
4040 LOCUST STREET
PHILADELPHIA
PA
19104
0
0
1
0
0001710037
First Round Capital Management IV, LLC
4040 LOCUST STREET
PHILADELPHIA
PA
19104
0
0
1
0
0001547073
First Round Capital IV Partners Fund, L.P.
4040 LOCUST STREET
PHILADELPHIA
PA
19104
0
0
1
0
0001710157
Barnes Phineas
4040 LOCUST STREET
PHILADELPHIA
PA
19104
0
0
1
0
0001701579
Fralic Christopher
4040 LOCUST STREET
PHILADELPHIA
PA
19104
0
0
1
0
0001710113
Hayes Robert
4040 LOCUST STREET
PHILADELPHIA
PA
19104
0
0
1
0
0001512421
Kopelman Joshua
4040 LOCUST STREET
PHILADELPHIA
PA
19104
0
0
1
0
0001710102
Trenchard William
4040 LOCUST STREET
PHILADELPHIA
PA
19104
0
0
1
0
Series A Preferred Stock
2017-07-05
4
C
0
195901
0
D
Class B Common Stock
9795071
0
I
See Footnote
Series A Preferred Stock
2017-07-05
4
C
0
3422
0
D
Class B Common Stock
171079
0
I
See Footnote
Series B Preferred Stock
2017-07-05
4
C
0
86035
0
D
Class B Common Stock
4301765
0
I
See Footnote
Series B Preferred Stock
2017-07-05
4
C
0
1503
0
D
Class B Common Stock
75135
0
I
See Footnote
Series C Preferred Stock
2017-07-05
4
C
0
320723
0
D
Class B Common Stock
1603615
0
I
See Footnote
Series C Preferred Stock
2017-07-05
4
C
0
5602
0
D
Class B Common Stock
28010
0
I
See Footnote
Series D Preferred Stock
2017-07-05
4
C
0
7375
0
D
Class B Common Stock
7375
0
I
See Footnote
Series D Preferred Stock
2017-07-05
4
C
0
129
0
D
Class B Common Stock
129
0
I
See Footnote
Class B Common Stock
2017-07-05
4
C
0
15707826
0
A
Class A Common Stock
15707826
15707826
I
See Footnote
Class B Common Stock
2017-07-05
4
C
0
274353
0
A
Class A Common
274353
274353
I
See Footnote
The Series A Preferred Stock automatically converted into Class B Common Stock on a 50:1 basis upon the closing of the Issuer's initial public offering of its Class A Common Stock and had no expiration date.
The Class B Common Stock is convertible into the Issuer's Class A Common Stock on a one-for-one basis upon certain transfers of such shares and at the holder's election and has no expiration date.
The reported shares are directly owned by First Round Capital IV, LP. ("FRC IV LP"). First Round Capital Management IV, L.P., the general partner of FRC IV LP, and First Round Capital Management IV, LLC, the general partner of First Round Capital Management IV, L.P., have sole dispositive and voting power of the shares directly owned by FRC IV LP, and Phineas Barnes, Christopher Fralic, Robert Hayes, Joshua Kopelman and William Trenchard may be deemed to have shared dispositive and voting power over such shares. Such persons and entities disclaim beneficial ownership over the shares held FRC IV LP except to the extent of any pecuniary interest therein.
The reported shares are owned directly by First Round Capital IV Partners Fund, L.P. First Round Capital Management IV, L.P. the general partner of FRC IV LP, and First Round Capital Management IV, LLC, the general partner of First Round Capital Management IV, L.P., have sole dispositive and voting power of the shares directly owned by FRC IV LP, and Phineas Barnes, Christopher Fralic, Robert Hayes, Joshua Kopelman and William Trenchard may be deemed to have shared dispositive and voting power over such shares. Such persons and entities disclaim beneficial ownership over the shares held FRC IV LP except to the extent of any pecuniary interest therein.
The Series B Preferred Stock automatically converted into Class B Common Stock on a 50:1 basis upon the closing of the Issuer's initial public offering of its Class A Common Stock and had no expiration date.
The Series C Preferred Stock automatically converted into Class B Common Stock on a 5:1 basis upon the closing of the Issuer's initial public offering of its Class A Common Stock and had no expiration date.
The Series D Preferred Stock automatically converted into Class B Common Stock on a 1:1 basis upon the closing of the Issuer's initial public offering of its Class A Common Stock and had no expiration date.
/s/ Jeffrey Donnon, Attorney-in-Fact for First Round Capital IV, L.P.
2017-07-05
/s/ Jeffrey Donnon, Attorney-in-Fact for First Round Capital Management IV, L.P.
2017-07-05
/s/ Jeffrey Donnon, Attorney-in-Fact for First Round Capital Management IV, LLC
2017-07-05
/s/ Jeffrey Donnon, Attorney-in-Fact for Phineas Barnes
2017-07-05
/s/ Jeffrey Donnon, Attorney-in-Fact for Christopher Fralic
2017-07-05
/s/ Jeffrey Donnon, Attorney-in-Fact for Robert Hayes
2017-07-05
/s/ Jeffrey Donnon, Attorney-in-Fact for Joshua Kopelman
2017-07-05
/s/ Jeffrey Donnon, Attorney-in-Fact for William Trenchard
2017-07-05