0001209191-18-051096.txt : 20180914
0001209191-18-051096.hdr.sgml : 20180914
20180914164115
ACCESSION NUMBER: 0001209191-18-051096
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180912
FILED AS OF DATE: 20180914
DATE AS OF CHANGE: 20180914
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Hazard Charles M Jr
CENTRAL INDEX KEY: 0001339247
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38240
FILM NUMBER: 181071597
MAIL ADDRESS:
STREET 1: 136 SUDBURY ROAD
CITY: WESTON
STATE: MA
ZIP: 02493
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: MongoDB, Inc.
CENTRAL INDEX KEY: 0001441816
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0131
BUSINESS ADDRESS:
STREET 1: 229 W. 43RD STREET
STREET 2: 5TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
BUSINESS PHONE: 866-237-8815
MAIL ADDRESS:
STREET 1: 229 W. 43RD STREET
STREET 2: 5TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
FORMER COMPANY:
FORMER CONFORMED NAME: 10GEN INC
DATE OF NAME CHANGE: 20080801
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-09-12
0
0001441816
MongoDB, Inc.
MDB
0001339247
Hazard Charles M Jr
C/O FLYBRIDGE CAPITAL PARTNERS
31 ST. JAMES AVENUE, 6TH FLOOR
BOSTON
MA
02116
1
0
1
0
Class A Common Stock
2018-09-12
4
C
0
2004640
0.00
A
2004640
I
By Limited Partnership
Class A Common Stock
2018-09-12
4
J
0
2004640
0.00
D
0
I
By Limited Partnership
Class A Common Stock
2018-09-12
4
J
0
17278
0.00
A
18612
I
By Trust
Class A Common Stock
2018-09-12
4
J
0
68731
0.00
A
77171
D
Class B Common Stock
2018-09-12
4
C
0
2004640
D
Class A Common Stock
2004640
1226219
I
By Limited Partnership
Each share of Class B Common Stock is convertible at any time at the option of the holder into one share of Class A Common Stock and has no expiration date. The Class B Common Stock will convert automatically into Class A Common Stock on the same basis upon the earlier of: (i) any transfer, whether or not for value, except for certain "Permitted Transfers" as defined in the Issuer's restated certificate of incorporation, and (ii) at such time as the outstanding shares of Class B common stock represent less than 10% of the aggregate number of shares of the Issuer's capital stock outstanding.
The Reporting Person is one of three managing members of Flybridge Capital Partners GP III, LLC, the General Partner of each of Flybridge Capital Partners III, L.P. ("Flybridge Capital") and Flybridge Network Fund III, L.P. ("Flybridge Network") and, as such, shares voting and dispositive power over the shares held by each of Flybridge Capital and Flybridge Network. The Reporting Person disclaims beneficial ownership of the shares owned by each of Flybridge Capital and Flybridge Network except to the extent of his pecuniary interest therein and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose.
2,000,000 of these shares are owned by Flybridge Capital and 4,640 of these shares are owned by Flybridge Network.
Represents a distribution without additional consideration of (a) 2,000,000 shares of Class A Common Stock by Flybridge Capital to its general and limited partners and (b) 4,640 shares of Class A Common Stock by Flybridge Network to its limited partners.
Represents the receipt by The Narragansett Bay Childrens Trust (the "Trust") of 17,278 shares of Class A Common Stock in the distribution by Flybridge Capital for no consideration as more fully described in footnote 4 herein. The Reporting Person is the Trustee of the Trust and, as such, has the power to vote and dispose of the shares held by the Trust. The Reporting Person disclaims beneficial ownership of the shares owned by the Trust except to the extent of his pecuniary interest therein and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
Represents the receipt by the Reporting Person of 68,731 shares of Class A Common Stock in the distribution by Flybridge Capital for no consideration as more specifically described in footnote 4 herein.
1,223,379 of these shares are owned by Flybridge Capital and 2,840 of these shares are owned by Flybridge Network.
/s/ Sarah Ward, Attorney-in-Fact
2018-09-14