FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 04/15/2015 |
3. Issuer Name and Ticker or Trading Symbol
ETSY INC [ ETSY ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 4,014,250 | D(1) | |
Common Stock | 140,079 | D(2) | |
Common Stock | 20,896 | D(3) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series A Preferred Stock | (4) | (4) | Common Stock | 1,404,470 | (4) | D(1) | |
Series A Preferred Stock | (4) | (4) | Common Stock | 49,000 | (4) | D(2) | |
Series A Preferred Stock | (4) | (4) | Common Stock | 7,305 | (4) | D(3) | |
Series A-1 Preferred Stock | (4) | (4) | Common Stock | 2,235,325 | (4) | D(1) | |
Series A-1 Preferred Stock | (4) | (4) | Common Stock | 77,985 | (4) | D(2) | |
Series A-1 Preferred Stock | (4) | (4) | Common Stock | 11,635 | (4) | D(3) | |
Series B Preferred Stock | (4) | (4) | Common Stock | 1,397,765 | (4) | D(1) | |
Series B Preferred Stock | (4) | (4) | Common Stock | 48,770 | (4) | D(2) | |
Series B Preferred Stock | (4) | (4) | Common Stock | 7,270 | (4) | D(3) | |
Series C Preferred Stock | (4) | (4) | Common Stock | 173,815 | (4) | D(1) | |
Series C Preferred Stock | (4) | (4) | Common Stock | 6,065 | (4) | D(2) | |
Series C Preferred Stock | (4) | (4) | Common Stock | 905 | (4) | D(3) | |
Series E Preferred Stock | (4) | (4) | Common Stock | 1,210,910 | (4) | D(1) | |
Series E Preferred Stock | (4) | (4) | Common Stock | 42,245 | (4) | D(2) | |
Series E Preferred Stock | (4) | (4) | Common Stock | 6,295 | (4) | D(3) | |
Series F Preferred Stock | (5) | (5) | Common Stock | 1,658,829 | (5) | D(1) | |
Series F Preferred Stock | (5) | (5) | Common Stock | 57,872 | (5) | D(2) | |
Series F Preferred Stock | (5) | (5) | Common Stock | 8,626 | (5) | D(3) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. The shares are held by Index Ventures Growth I (Jersey), L.P. Index Venture Growth Associates I Limited is the managing general partner of Index Ventures Growth I (Jersey), L.P. Nigel T. Greenwood, David Hall, Ian J. Henderson, Phil Balderson, Bernard Dalle and Sinead Meehan are directors of Index Venture Growth Associates I Limited. Mrs. Meehan and Messrs. Greenwood, Hall, Henderson, Balderson and Dalle share voting and dispositive power with respect to the shares. Each of these persons disclaims beneficial ownership of the shares except to the extent of his or her pecuniary interest therein. |
2. The shares are held by Index Ventures Growth I Parallel Entrepreneur Fund (Jersey), L.P. Index Venture Growth Associates I Limited is the managing general partner of Index Ventures Growth I Parallel Entrepreneur Fund (Jersey), L.P. Nigel T. Greenwood, David Hall, Ian J. Henderson, Phil Balderson, Bernard Dalle and Sinead Meehan are directors of Index Venture Growth Associates I Limited. Mrs. Meehan and Messrs. Greenwood, Hall, Henderson, Balderson and Dalle share voting and dispositive power with respect to the shares. Each of these persons disclaims beneficial ownership of the shares except to the extent of his or her pecuniary interest therein. |
3. The shares are held by Yucca (Jersey), SLP. The above shares represent securities held in a coinvestment fund that is contractually required to mirror Index Venture Growth Associates I Limited's investment. As a result, Mrs. Meehan and Messrs. Greenwood, Hall, Henderson, Balderson and Dalle may be deemed to have voting and dispositive power over Yucca (Jersey), SLP's shares by virtue of its shared dispositive power over and shared voting power over the shares held by Index Venture Growth Associates I Limited. Each of these persons disclaims beneficial ownership of the securities except to the extent of his or her pecuniary interest therein. |
4. In connection with the completion of the Issuer's initial public offering of Common Stock, each share of Series A Preferred Stock, Series A-1 Preferred Stock, Series B Preferred Stock, Series C Preferred Stock, and Series E Preferred Stock shall be automatically converted into five shares of common stock of the Issuer. The Series A Preferred Stock, Series A-1 Preferred Stock, Series B Preferred Stock, Series C Preferred Stock, and Series E Preferred Stock have no expiration date. The number of underlying shares of Common Stock is shown in the table above. |
5. In connection with the completion of the Issuer's initial public offering of Common Stock, each share of Series F Preferred Stock shall be automatically converted into 0.5 shares of common stock of the Issuer. The Series F Preferred Stock has no expiration date. The number of underlying shares of Common Stock is shown in the table above. |
Remarks: |
INDEX VENTURES GROWTH I (JERSEY), L.P. by its Managing General Partner: Index Venture Growth Associates I Limited /s/ Nigel Greenwood, Director | 04/15/2015 | |
INDEX VENTURES GROWTH I PARALLEL ENTREPRENEUR FUND (JERSEY) L.P. by its Managing General Partner: Index Venture Growth Associates I Limited /s/ Nigel Greenwood, Director | 04/15/2015 | |
Elian Employee Benefit Services Limited as Authorized Signatory of YUCCA (JERSEY) SLP in its capacity of Administrator of the Index Co-Investment Scheme /s/ Giles Johnstone-Scott, Authorized Signatory | 04/15/2015 | |
Elian Employee Benefit Services Limited as Authorized Signatory of YUCCA (JERSEY) SLP in its capacity of Administrator of the Index Co-Investment Scheme /s/ Alex Di Santo, Authorized Signatory | 04/15/2015 | |
INDEX VENTURE GROWTH ASSOCIATES I LIMITED /s/ Nigel Greenwood, Director | 04/15/2015 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |