0001127602-24-017110.txt : 20240531
0001127602-24-017110.hdr.sgml : 20240531
20240531161038
ACCESSION NUMBER: 0001127602-24-017110
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240529
FILED AS OF DATE: 20240531
DATE AS OF CHANGE: 20240531
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Sarafan Lily
CENTRAL INDEX KEY: 0001736341
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41805
FILM NUMBER: 241009767
MAIL ADDRESS:
STREET 1: C/O COUNSYL, INC.
STREET 2: 180 KIMBALL WAY
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Maplebear Inc.
CENTRAL INDEX KEY: 0001579091
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
ORGANIZATION NAME: 07 Trade & Services
IRS NUMBER: 460723335
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 50 BEALE STREET, SUITE 600
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
BUSINESS PHONE: (888) 246-7822
MAIL ADDRESS:
STREET 1: 50 BEALE STREET, SUITE 600
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
4
1
form4.xml
PRIMARY DOCUMENT
X0508
4
2024-05-29
0001579091
Maplebear Inc.
CART
0001736341
Sarafan Lily
C/O MAPLEBEAR INC.
50 BEALE STREET, SUITE 600
SAN FRANCISCO
CA
94105
1
0
Common Stock
2024-05-29
4
A
0
6841
0
A
18874
D
The shares represent restricted stock units, which vest in full on the earlier of (i) the date of the Issuer's next annual meeting of stockholders (or the date immediately prior to such meeting if the Reporting Person's service as a director ends at such meeting due to the Reporting Person's failure to be re-elected or the Reporting Person not standing for re-election) or (ii) the one-year anniversary of the grant date, in each case subject to the Reporting Person's continued service through such date.
/s/ Bradley Libuit, Attorney-in-Fact
2024-05-31