0000899243-21-047837.txt : 20211210 0000899243-21-047837.hdr.sgml : 20211210 20211210211446 ACCESSION NUMBER: 0000899243-21-047837 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211208 FILED AS OF DATE: 20211210 DATE AS OF CHANGE: 20211210 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Welihinda Navam CENTRAL INDEX KEY: 0001894706 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41121 FILM NUMBER: 211486797 MAIL ADDRESS: STREET 1: C/O HASHICORP INC. STREET 2: 101 SECOND STREET, SUITE 700 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HashiCorp, Inc. CENTRAL INDEX KEY: 0001720671 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING SERVICES [7371] IRS NUMBER: 320410665 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 101 2ND STREET, SUITE 700 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: 415-301-3227 MAIL ADDRESS: STREET 1: 101 2ND STREET, SUITE 700 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-12-08 0 0001720671 HashiCorp, Inc. HCP 0001894706 Welihinda Navam C/O HASHICORP, INC. 101 SECOND STREET, SUITE 700 SAN FRANCISCO CA 94105 0 1 0 0 Chief Financial Officer Common Stock 2021-12-08 4 A 0 121000 0.00 A 301028 D Common Stock 2021-12-08 4 A 0 95000 0.00 A 396028 D Immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock, each share of Common Stock shall be reclassified into one share of Class B Common Stock. The reported shares are represented by restricted stock units, or RSUs, which vest as to 25% on January 31, 2022 and the remaining shares vest in twelve equal quarterly installments beginning on March 20, 2022. Immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock, each share underlying these RSUs shall be reclassified into one share of Class B Common Stock. The reported shares are represented by RSUs which vest as to 50% on December 9, 2023 and the remaining shares vest in eight equal quarterly installments beginning on December 20, 2023. Immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock, each share underlying these RSUs shall be reclassified into one share of Class A Common Stock. /s/ Paul Warenski, by power of attorney 2021-12-10