0001209191-21-047630.txt : 20210721 0001209191-21-047630.hdr.sgml : 20210721 20210721193438 ACCESSION NUMBER: 0001209191-21-047630 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210721 FILED AS OF DATE: 20210721 DATE AS OF CHANGE: 20210721 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SORENSON CAPITAL PARTNERS III, LP CENTRAL INDEX KEY: 0001593258 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40601 FILM NUMBER: 211105618 BUSINESS ADDRESS: STREET 1: 3400 N. ASHTON BOULEVARD, SUITE 400 CITY: LEHI STATE: UT ZIP: 84043 BUSINESS PHONE: 801-407-8400 MAIL ADDRESS: STREET 1: 3400 N. ASHTON BOULEVARD, SUITE 400 CITY: LEHI STATE: UT ZIP: 84043 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SORENSON CAPITAL PARTNERS III-A, LP CENTRAL INDEX KEY: 0001593259 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40601 FILM NUMBER: 211105617 BUSINESS ADDRESS: STREET 1: 3400 N. ASHTON BOULEVARD, SUITE 400 CITY: LEHI STATE: UT ZIP: 84043 BUSINESS PHONE: 801-407-8400 MAIL ADDRESS: STREET 1: 3400 N. ASHTON BOULEVARD, SUITE 400 CITY: LEHI STATE: UT ZIP: 84043 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SORENSON CAPITAL PARTNERS III-B, LP CENTRAL INDEX KEY: 0001593261 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40601 FILM NUMBER: 211105616 BUSINESS ADDRESS: STREET 1: 3400 N. ASHTON BOULEVARD, SUITE 400 CITY: LEHI STATE: UT ZIP: 84043 BUSINESS PHONE: 801-407-8400 MAIL ADDRESS: STREET 1: 3400 N. ASHTON BOULEVARD, SUITE 400 CITY: LEHI STATE: UT ZIP: 84043 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Couchbase, Inc. CENTRAL INDEX KEY: 0001845022 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 263576987 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 3250 OLCOTT STREET CITY: SANTA CLARA STATE: CA ZIP: 95054 BUSINESS PHONE: 6504177500 MAIL ADDRESS: STREET 1: 3250 OLCOTT STREET CITY: SANTA CLARA STATE: CA ZIP: 95054 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2021-07-21 0 0001845022 Couchbase, Inc. BASE 0001593258 SORENSON CAPITAL PARTNERS III, LP 3400 ASHTON BOULEVARD, #400 LEHI UT 84043 0 0 1 0 0001593259 SORENSON CAPITAL PARTNERS III-A, LP 3400 ASHTON BOULEVARD, #400 LEHI UT 84043 0 0 1 0 0001593261 SORENSON CAPITAL PARTNERS III-B, LP 3400 ASHTON BOULEVARD, #400 LEHI UT 84043 0 0 1 0 Common Stock 157736 I By: SCP Couchbase Acquisition, L.L.C. Series F Preferred Stock 0.00 Common Stock 2156007 I By: SCP Couchbase Acquisition, L.L.C. Series G Preferred Stock 0.00 Common Stock 1024048 I By: SCP Couchbase Acquisition, L.L.C. Sorenson Capital Partners III, LP ("SCP III"), Sorenson Capital Partners III-A, LP ("SCP III-A"), Sorenson Capital Partners III-B, LP ("SCP III-B") and Sorensen Capital Investment Partner III, LP ("SCIP III") are the members of SCP Couchbase Acquisition L.L.C. Sorenson Capital Associates III, LP is the general partner of each of SCP III, SCP III-A and SCP III-B. West Rim Capital Advisors, LP is the general partner of SCIP III. West Rim Capital Advisors, LLC ("West Rim Capital") is the general partner of each of Sorenson Capital Associates III, LP and West Rim Capital Advisors, LP. Rob Rueckert is a member of the Issuer's board of directors and the president of SCP Couchbase Acquisition, L.L.C. Each of Mark Ludwig, Ron Mika, Rob Rueckert and Luke Sorenson are partners of West Rim Capital and therefore may be deemed to have shared voting and dispositive power with respect to the shares held by SCP Couchbase Acquisition L.L.C. (continuation of FN 1): Each of the foregoing entities and individuals disclaim beneficial ownership of such shares except to the extent of their pecuniary interest therein. The address for each of the Sorenson entities listed above is 3400 Ashton Boulevard #400, Lehi, Utah 84043. Immediately prior to the completion of the Issuer's initial public offering, each share of Series F Preferred Stock is convertible into shares of the Issuer's Common Stock, par value $0.00001 per share, on a one-for-one basis and has no expiration date. Immediately prior to the completion of the Issuer's initial public offering, each share of Series G Preferred Stock is convertible into shares of the Issuer's Common Stock, par value $0.00001 per share, on an expected 1.06673317089756-for-one basis and has no expiration date. Sorenson Capital Partners III, LP, /s/ Rob Rueckert, Authorized Signatory 2021-07-21 Sorenson Capital Partners III-A, LP, /s/ Rob Rueckert, Authorized Signatory 2021-07-21 Sorenson Capital Partners III-B, LP, /s/ Rob Rueckert, Authorized Signatory 2021-07-21