0001104659-18-030338.txt : 20180503
0001104659-18-030338.hdr.sgml : 20180503
20180503180048
ACCESSION NUMBER: 0001104659-18-030338
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180503
FILED AS OF DATE: 20180503
DATE AS OF CHANGE: 20180503
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Cluff Jared
CENTRAL INDEX KEY: 0001710331
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38134
FILM NUMBER: 18805322
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
2018-05-03
0
0001701114
Blue Apron Holdings, Inc.
APRN
0001710331
Cluff Jared
C/O BLUE APRON HOLDINGS, INC.
40 WEST 23RD STREET
NEW YORK
NY
10010
0
1
0
0
Chief Marketing Officer
Class A Common Stock
2018-05-03
4
C
0
50000
0
A
50000
D
Class B Common Stock
2018-05-03
4
C
0
50000
0
D
Class A Common Stock
50000
0
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 Jared Cluff
2018-05-03