0001209191-21-067602.txt : 20211202 0001209191-21-067602.hdr.sgml : 20211202 20211202163511 ACCESSION NUMBER: 0001209191-21-067602 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211201 FILED AS OF DATE: 20211202 DATE AS OF CHANGE: 20211202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Antar Alvina CENTRAL INDEX KEY: 0001891718 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40601 FILM NUMBER: 211467094 MAIL ADDRESS: STREET 1: C/O COUCHBASE, INC. STREET 2: 3250 OLCOTT STREET CITY: SANTA CLARA STATE: CA ZIP: 95054 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Couchbase, Inc. CENTRAL INDEX KEY: 0001845022 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 263576987 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 3250 OLCOTT STREET CITY: SANTA CLARA STATE: CA ZIP: 95054 BUSINESS PHONE: 6504177500 MAIL ADDRESS: STREET 1: 3250 OLCOTT STREET CITY: SANTA CLARA STATE: CA ZIP: 95054 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-12-01 0 0001845022 Couchbase, Inc. BASE 0001891718 Antar Alvina C/O COUCHBASE, INC. 3250 OLCOTT STREET SANTA CLARA CA 95054 1 0 0 0 Common Stock 2021-12-01 4 A 0 7512 0.00 A 7512 D This represents an award of restricted stock units to the Issuer's non-employee director. Each unit represents a contingent right to receive one share of the Issuer's common stock upon vesting. One-third (1/3) of these restricted stock units will vest annually over a 3-year period from December 1, 2021, subject to the Reporting Person's continued service with the Issuer through each such vesting date. /s/ Margaret Chow, by Power of Attorney for Alvina Antar 2021-12-02