0001209191-21-057094.txt : 20210921
0001209191-21-057094.hdr.sgml : 20210921
20210921181504
ACCESSION NUMBER: 0001209191-21-057094
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210921
FILED AS OF DATE: 20210921
DATE AS OF CHANGE: 20210921
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FOGELSONG NORMAN A
CENTRAL INDEX KEY: 0001140932
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40817
FILM NUMBER: 211267454
MAIL ADDRESS:
STREET 1: C/O IVP
STREET 2: 3000 SAND HILL ROAD, 2-250
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Phelps Dennis B
CENTRAL INDEX KEY: 0001299965
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40817
FILM NUMBER: 211267449
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: 2-250
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Harrick Stephen J
CENTRAL INDEX KEY: 0001299975
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40817
FILM NUMBER: 211267453
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: 2-250
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Chaffee Todd C
CENTRAL INDEX KEY: 0001300134
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40817
FILM NUMBER: 211267456
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: 2-250
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Miller J Sanford
CENTRAL INDEX KEY: 0001359524
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40817
FILM NUMBER: 211267450
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 2, SUITE 250
CITY: MENLO PARK
STATE: CA
ZIP: 94025
FORMER NAME:
FORMER CONFORMED NAME: Miller J Sanford (Sandy)
DATE OF NAME CHANGE: 20060414
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Maltz Jules A.
CENTRAL INDEX KEY: 0001553254
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40817
FILM NUMBER: 211267451
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 2, SUITE 250
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Institutional Venture Partners XV, L.P.
CENTRAL INDEX KEY: 0001640274
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40817
FILM NUMBER: 211267457
BUSINESS ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 2, SUITE 250
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650 854 0132
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 2, SUITE 250
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Institutional Venture Management XV, LLC
CENTRAL INDEX KEY: 0001640275
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40817
FILM NUMBER: 211267458
BUSINESS ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 2, SUITE 250
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650 854 0132
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 2, SUITE 250
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Liaw Eric
CENTRAL INDEX KEY: 0001644264
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40817
FILM NUMBER: 211267452
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 2, SUITE 250
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Dash Somesh
CENTRAL INDEX KEY: 0001843938
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40817
FILM NUMBER: 211267455
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 2, SUITE 250
CITY: MENLO PARK
STATE: CA
ZIP: 94025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Amplitude, Inc.
CENTRAL INDEX KEY: 0001866692
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 201 THIRD STREET, SUITE 200
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94103
BUSINESS PHONE: 510 473-5668
MAIL ADDRESS:
STREET 1: 201 THIRD STREET, SUITE 200
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94103
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2021-09-21
0
0001866692
Amplitude, Inc.
AMPL
0001640275
Institutional Venture Management XV, LLC
300 SAND HILL ROAD, BUILDING 2
SUITE 250
MENLO PARK
CA
94025
0
0
1
0
0001640274
Institutional Venture Partners XV, L.P.
300 SAND HILL ROAD, BUILDING 2
SUITE 250
MENLO PARK
CA
94025
0
0
1
0
0001300134
Chaffee Todd C
300 SAND HILL ROAD, BUILDING 2
SUITE 250
MENLO PARK
CA
94025
0
0
1
0
0001843938
Dash Somesh
300 SAND HILL ROAD, BUILDING 2
SUITE 250
MENLO PARK
CA
94025
0
0
1
0
0001140932
FOGELSONG NORMAN A
300 SAND HILL ROAD, BUILDING2,
SUITE 250
MENLO PARK
CA
94025
0
0
1
0
0001299975
Harrick Stephen J
300 SAND HILL ROAD, BUILDING 2
SUITE 250
MENLO PARK
CA
94025
0
0
1
0
0001644264
Liaw Eric
300 SAND HILL ROAD, BUILDING 2
SUITE 250
MENLO PARK
CA
94025
0
0
1
0
0001553254
Maltz Jules A.
300 SAND HILL ROAD, BUILDING 2
SUITE 250
MENLO PARK
CA
94025
0
0
1
0
0001359524
Miller J Sanford
300 SAND HILL ROAD, BUILDING 2
SUITE 250
MENLO PARK
CA
94025
0
0
1
0
0001299965
Phelps Dennis B
300 SAND HILL ROAD, BUILDING 2
SUITE 250
MENLO PARK
CA
94025
0
0
1
0
Class B Common Stock
0.00
Class A Common Stock
8716001
I
See footnote
Class B Common Stock
0.00
Class A Common Stock
46354
I
See footnote
The Class B Common Stock is convertible at any time at the option of the holder into the Issuer's Class A Common Stock on a one-to-one basis. The Class B Common Stock will convert automatically into shares of the Issuer's Class A Common Stock on a one-to-one basis upon the earlier of (a) any transfer of the Class B Common Stock by the holder, whether or not for value, subject to certain exceptions or (b) the date that is six months following the date on which none of the Issuer's founders is an employee or director of the Issuer (unless a founder has rejoined the Issuer during such six-month period).
These shares are owned directly by Institutional Venture Partners XV, L.P., of which Institutional Venture Management XV, LLC ("IVM XV") is the sole general partner and exercises voting and investment power over these shares. The managing directors of IVM XV are Todd C. Chaffee, Somesh Dash, Norman A. Fogelsong, Stephen J. Harrick, Eric Liaw, Jules A. Maltz, J. Sanford Miller and Dennis B. Phelps, Jr. The reporting persons disclaim beneficial ownership of these securities, except to the extent of their respective proportionate pecuniary interest therein and this report shall not be deemed an admission that any reporting person is the beneficial owner of such securities for Section 16 or any other purpose.
These shares are owned directly by Institutional Venture Partners XV Executive Fund, L.P., of which IVM XV is the sole general partner and exercises voting and investment power over these shares. The managing directors of IVM XV
are Todd C. Chaffee, Somesh Dash, Norman A. Fogelsong, Stephen J. Harrick, Eric Liaw, Jules A. Maltz, J. Sanford Miller and Dennis B. Phelps, Jr. The reporting persons disclaim beneficial ownership of these securities, except to the extent of their respective proportionate pecuniary interest therein and this report shall not be deemed an admission that any reporting person is the beneficial owner of such securities for Section 16 or any other purpose.
1 of 2: The number of joint filers exceeds the EDGAR maximum of 10 joint filers per Form. This Form 3 is being filed in conjunction with a Form 3 being filed by Institutional Venture Partners XV Executive Fund, L.P.
Institutional Venture Management XV, LLC, By: /s/ Tracy Hogan, Attorney-in-Fact
2021-09-21
Institutional Venture Partners XV, L.P., By: Institutional Venture Management XV, LLC, its general partner, By: /s/ Eric Liaw, managing member
2021-09-21
Todd C. Chaffee, By: /s/ Tracy Hogan, Attorney-in-Fact
2021-09-21
Somesh Dash, By: /s/ Tracy Hogan, Attorney-in-Fact
2021-09-21
Norman A. Fogelsong, By: /s/ Tracy Hogan, Attorney-in-Fact
2021-09-21
Stephen J. Harrick, By: /s/ Tracy Hogan, Attorney-in-Fact
2021-09-21
Eric Liaw, By: /s/ Tracy Hogan, Attorney-in-Fact
2021-09-21
Jules A. Maltz, By: /s/ Tracy Hogan, Attorney-in-Fact
2021-09-21
J. Sanford Miller, By: /s/ Tracy Hogan, Attorney-in-Fact
2021-09-21
Dennis B. Phelps, Jr., By: /s/ Tracy Hogan, Attorney-in-Fact
2021-09-21