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