0001104659-18-001019.txt : 20180105
0001104659-18-001019.hdr.sgml : 20180105
20180105173953
ACCESSION NUMBER: 0001104659-18-001019
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171212
FILED AS OF DATE: 20180105
DATE AS OF CHANGE: 20180105
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Papas Ilia M
CENTRAL INDEX KEY: 0001710361
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38134
FILM NUMBER: 18514378
MAIL ADDRESS:
STREET 1: 5 CROSBY STREET
CITY: NEW YORK
STATE: NY
ZIP: 10013
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
4
1
a4.xml
4
X0306
4
2017-12-12
0
0001701114
Blue Apron Holdings, Inc.
APRN
0001710361
Papas Ilia M
C/O BLUE APRON HOLDINGS, INC.
40 WEST 23RD STREET
NEW YORK
NY
10010
0
1
0
0
Chief Technology Officer
Class A Common Stock
2017-12-12
4
C
0
37500
0
A
37500
D
Class A Common Stock
2017-12-15
5
G
0
E
30000
0
D
7500
D
Class B Common Stock
2017-12-12
4
C
0
37500
0
D
Class A Common Stock
37500
6948043
D
Represents the number of shares that were acquired upon conversion of the shares of Class B Common Stock into Class A Common Stock listed in Table II.
The Class B Common Stock is convertible into the issuer's Class A Common Stock on a 1-for-1 basis upon certain transfers of such shares and at the holder's election and has no expiration date.
The holder elected to convert the shares of Class B Common Stock into Class A Common Stock on a 1-for-1 basis.
/s/ Benjamin C. Singer, as attorney-in-fact for Ilia M. Papas
2018-01-05