0000899243-21-048443.txt : 20211215 0000899243-21-048443.hdr.sgml : 20211215 20211215202505 ACCESSION NUMBER: 0000899243-21-048443 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211213 FILED AS OF DATE: 20211215 DATE AS OF CHANGE: 20211215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MAYFIELD XIV, A CAYMAN ISLANDS EXEMPTED LIMITED PARTNERSHIP CENTRAL INDEX KEY: 0001551568 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41121 FILM NUMBER: 211495604 BUSINESS ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650.854.5560 MAIL ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mayfield XIV Management (UGP), Ltd. CENTRAL INDEX KEY: 0001648252 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41121 FILM NUMBER: 211495602 BUSINESS ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 6508545560 MAIL ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mayfield XIV Management (EGP), L.P. CENTRAL INDEX KEY: 0001648253 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41121 FILM NUMBER: 211495603 BUSINESS ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 6508545560 MAIL ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MAYFIELD SELECT, A CAYMAN ISLANDS EXEMPTED LIMITED PARTNERSHIP CENTRAL INDEX KEY: 0001667217 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41121 FILM NUMBER: 211495601 BUSINESS ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650.854.5560 MAIL ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MF Leaders Management, L.L.C. CENTRAL INDEX KEY: 0001883973 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41121 FILM NUMBER: 211495597 BUSINESS ADDRESS: STREET 1: C/O MAYFIELD STREET 2: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: (650) 854-5560 MAIL ADDRESS: STREET 1: C/O MAYFIELD STREET 2: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mayfield Select Management (EGP), L.P. CENTRAL INDEX KEY: 0001708789 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41121 FILM NUMBER: 211495600 BUSINESS ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 6508545560 MAIL ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mayfield Select Management (UGP), Ltd. CENTRAL INDEX KEY: 0001708788 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41121 FILM NUMBER: 211495599 BUSINESS ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 6508545560 MAIL ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MF Leaders H-E, L.P. CENTRAL INDEX KEY: 0001807009 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41121 FILM NUMBER: 211495598 BUSINESS ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: (650) 854-5560 MAIL ADDRESS: STREET 1: 2484 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HashiCorp, Inc. CENTRAL INDEX KEY: 0001720671 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING SERVICES [7371] 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 X0306 4 2021-12-13 0 0001720671 HashiCorp, Inc. HCP 0001551568 MAYFIELD XIV, A CAYMAN ISLANDS EXEMPTED LIMITED PARTNERSHIP 2484 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001648253 Mayfield XIV Management (EGP), L.P. 2484 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001648252 Mayfield XIV Management (UGP), Ltd. 2484 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001667217 MAYFIELD SELECT, A CAYMAN ISLANDS EXEMPTED LIMITED PARTNERSHIP 2484 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001708789 Mayfield Select Management (EGP), L.P. 2484 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001708788 Mayfield Select Management (UGP), Ltd. 2484 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001807009 MF Leaders H-E, L.P. 2484 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001883973 MF Leaders Management, L.L.C. 2484 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 Common Stock 2021-12-13 4 C 0 25743304 A 26216776 I Mayfield XIV, a Cayman Islands Exempted Limited Partnership Common Stock 2021-12-13 4 C 0 3325602 A 3325602 I Mayfield Select, a Cayman Islands Exempted Limited Partnership Common Stock 2021-12-13 4 C 0 345778 A 345778 I MF Leaders H-E, L.P. Common Stock 2021-12-13 4 J 0 26216776 D 0 I Mayfield XIV, a Cayman Islands Exempted Limited Partnership Common Stock 2021-12-13 4 J 0 3325602 D 0 I Mayfield Select, a Cayman Islands Exempted Limited Partnership Common Stock 2021-12-13 4 J 0 345778 D 0 I MF Leaders H-E, L.P. Series A Convertible Preferred Stock 2021-12-13 4 C 0 18490454 0.00 D Common Stock 18490454 0 I Mayfield XIV, a Cayman Islands Exempted Limited Partnership Series B Convertible Preferred Stock 2021-12-13 4 C 0 7173942 0.00 D Common Stock 7173942 0 I Mayfield XIV, a Cayman Islands Exempted Limited Partnership Series C Convertible Preferred Stock 2021-12-13 4 C 0 78908 0.00 D Common Stock 78908 0 I Mayfield XIV, a Cayman Islands Exempted Limited Partnership Series C Convertible Preferred Stock 2021-12-13 4 C 0 3235376 0.00 D Common Stock 3235376 0 I Mayfield Select, a Cayman Islands Exempted Limited Partnership Series D Convertible Preferred Stock 2021-12-13 4 C 0 90226 0.00 D Common Stock 90226 0 I Mayfield Select, a Cayman Islands Exempted Limited Partnership Series E Convertible Preferred Stock 2021-12-13 4 C 0 345778 0.00 D Common Stock 345778 0 I MF Leaders H-E, L.P. Class B Common Stock 2021-12-13 4 J 0 26216776 A Class A Common Stock 26216776 26216776 I Mayfield XIV, a Cayman Islands Exempted Limited Partnership Class B Common Stock 2021-12-13 4 J 0 3325602 A Class A Common Stock 3325602 3325602 I Mayfield Select, a Cayman Islands Exempted Limited Partnership Class B Common Stock 2021-12-13 4 J 0 345778 A Class A Common Stock 345778 345778 I MF Leaders H-E, L.P. Each share of Series A Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock and had no expiration date. Each share of Series B Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock and had no expiration date. Each share of Series C Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock and had no expiration date. Mayfield XIV Management (UGP), Ltd., a Cayman Islands Exempted Company (MF XIV UGP), is the general partner of Mayfield XIV Management (EGP), L.P., a Cayman Islands Exempted Limited Partnership (MF XIV EGP), which is the general partner of Mayfield XIV, a Cayman Islands Exempted Limited Partnership (MF XIV). Rajeev Batra, Navin Chaddha, and Urshit Parikh, the directors of MF XIV UGP, may be deemed to share beneficial ownership of the shares owned by MF XIV, but each of the individuals disclaims such beneficial ownership. Each share of Series D Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock and had no expiration date. Mayfield Select Management (UGP), Ltd., a Cayman Islands Exempted Company (MF Select UGP), is the general partner of Mayfield Select Management (EGP), L.P., a Cayman Islands Exempted Limited Partnership (MF Select EGP), which is the general partner of Mayfield Select, a Cayman Islands Exempted Limited Partnership (MF Select). Messrs. Batra, Chaddha, and Parikh, the directors of MF Select UGP, may be deemed to share beneficial ownership of the shares owned by MF Select, but each of the individuals disclaims such beneficial ownership. Each share of Series E Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock and had no expiration date. MF Leaders Management, L.L.C. (MF Leaders GP) is the general partner of MF Leaders H-E, L.P. (MF Leaders). Mr. Chaddha, the sole member of MF Leaders GP, may be deemed to share beneficial ownership of the shares owned by MF Leaders, but disclaims such beneficial ownership. Pursuant to a reclassification exempt under Rule 16b-7, each share of Common Stock was automatically reclassified into one share of Class B Common Stock immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock. Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis at the reporting person's election and has no expiration date. MAYFIELD XIV, a Cayman Islands Exempted Limited Partnership, By: MAYFIELD XIV MANAGEMENT (EGP), L.P., its General Partner, By: MAYFIELD XIV MANAGEMENT (UGP), LTD., its General Partner, By: /s/ Paul Kohli, Authorized Signatory 2021-12-15 MAYFIELD XIV MANAGEMENT (EGP), L.P., By: MAYFIELD XIV MANAGEMENT (UGP), LTD., its General Partner, By: /s/ Paul Kohli, Authorized Signatory 2021-12-15 MAYFIELD XIV MANAGEMENT (UGP), LTD., By: /s/ Paul Kohli, Authorized Signatory 2021-12-15 MAYFIELD SELECT, a Cayman Islands Exempted Limited Partnership, By: MAYFIELD SELECT MANAGEMENT (EGP), L.P., its General Partner, By: MAYFIELD SELECT MANAGEMENT (UGP), LTD., its General Partner, By: /s/ Paul Kohli, Authorized Signatory 2021-12-15 MAYFIELD SELECT MANAGEMENT (EGP), L.P., By: MAYFIELD SELECT MANAGEMENT (UGP), LTD., its General Partner, By: /s/ Paul Kohli, Authorized Signatory 2021-12-15 MAYFIELD SELECT MANAGEMENT (UGP), LTD., By: /s/ Paul Kohli, Authorized Signatory 2021-12-15 MF LEADERS H-E, L.P., a Delaware limited partnership, By: MF Leaders Management, L.L.C., its General Partner, By: /s/ Paul Kohli, Authorized Signatory 2021-12-15 MF Leaders Management, L.L.C., By: /s/ Paul Kohli, Authorized Signatory 2021-12-15