0001104659-21-081133.txt : 20210615 0001104659-21-081133.hdr.sgml : 20210615 20210615064202 ACCESSION NUMBER: 0001104659-21-081133 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210614 FILED AS OF DATE: 20210615 DATE AS OF CHANGE: 20210615 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Carr-Smith Jennifer CENTRAL INDEX KEY: 0001828401 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38134 FILM NUMBER: 211016849 MAIL ADDRESS: STREET 1: 28 LIBERTY STREET CITY: NEW YORK STATE: NY ZIP: 10005 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: 28 LIBERTY STREET CITY: NEW YORK STATE: NY ZIP: 10005 BUSINESS PHONE: 347-719-4312 MAIL ADDRESS: STREET 1: 28 LIBERTY STREET CITY: NEW YORK STATE: NY ZIP: 10005 4 1 tm2119720-4_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2021-06-14 0 0001701114 Blue Apron Holdings, Inc. APRN 0001828401 Carr-Smith Jennifer C/O BLUE APRON HOLDINGS, INC. 28 LIBERTY STREET NEW YORK NY 10005 1 0 0 0 Restricted Stock Units 2021-06-14 4 A 0 12494 0 A Class A Common Stock 12494 12494 D Each restricted stock unit ("RSU") represents a contingent right to receive one share of Class A Common Stock. The RSUs are scheduled to vest in full on the earlier of June 14, 2022 and the date of the issuer's 2022 annual meeting of stockholders. The Reporting Person has elected to defer settlement of the shares of Class A common stock underlying these RSUs until the earlier of (i) 30 days following the Reporting Person's "separation from service" with the issuer and (ii) a "change in control event," each as defined under Section 409A of the Internal Revenue Code of 1986, as amended. /s/ Meredith Deutsch, as attorney-in-fact for Jennifer Carr-Smith 2021-06-15