0001209191-21-048265.txt : 20210726
0001209191-21-048265.hdr.sgml : 20210726
20210726213805
ACCESSION NUMBER: 0001209191-21-048265
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210726
FILED AS OF DATE: 20210726
DATE AS OF CHANGE: 20210726
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: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40601
FILM NUMBER: 211115738
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: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40601
FILM NUMBER: 211115737
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: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40601
FILM NUMBER: 211115736
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-07-26
1
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
2021-07-26
4
C
0
3248392
A
3406128
I
By: SCP Couchbase Acquisition, L.L.C.
Series F Preferred Stock
2021-07-26
4
C
0
2156007
0.00
D
Common Stock
2156007
0
I
By: SCP Couchbase Acquisition, L.L.C.
Series G Preferred Stock
2021-07-26
4
C
0
1024048
0.00
D
Common Stock
1092385
0
I
By: SCP Couchbase Acquisition, L.L.C.
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 a 1.06673317089756-for-one basis and has no expiration date.
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 2): 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.
Sorenson Capital Partners III, LP, /s/ Rob Rueckert, Authorized Signatory
2021-07-26
Sorenson Capital Partners III-A, LP, /s/ Rob Rueckert, Authorized Signatory
2021-07-26
Sorenson Capital Partners III-B, LP, /s/ Rob Rueckert, Authorized Signatory
2021-07-26