0000899243-21-044224.txt : 20211110 0000899243-21-044224.hdr.sgml : 20211110 20211110213254 ACCESSION NUMBER: 0000899243-21-044224 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20211110 FILED AS OF DATE: 20211110 DATE AS OF CHANGE: 20211110 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: 001-41059 FILM NUMBER: 211398707 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: 001-41059 FILM NUMBER: 211398705 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: 001-41059 FILM NUMBER: 211398706 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: 001-41059 FILM NUMBER: 211398709 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: 001-41059 FILM NUMBER: 211398704 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: Dash Somesh CENTRAL INDEX KEY: 0001843938 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211398708 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: 001-41059 FILM NUMBER: 211398711 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: 001-41059 FILM NUMBER: 211398713 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 Partners XV Executive Fund, L.P. CENTRAL INDEX KEY: 0001661321 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211398712 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: Maltz Jules A. CENTRAL INDEX KEY: 0001553254 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41059 FILM NUMBER: 211398710 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: Lulu's Fashion Lounge Holdings, Inc. CENTRAL INDEX KEY: 0001780201 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-CATALOG & MAIL-ORDER HOUSES [5961] IRS NUMBER: 208442468 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 195 HUMBOLDT AVENUE CITY: CHICO STATE: CA ZIP: 95928 BUSINESS PHONE: 530-343-3545 MAIL ADDRESS: STREET 1: 195 HUMBOLDT AVENUE CITY: CHICO STATE: CA ZIP: 95928 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2021-11-10 0 0001780201 Lulu's Fashion Lounge Holdings, Inc. LVLU 0001640275 Institutional Venture Management XV, LLC 3000 SAND HILL ROAD BUILDING 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001661321 Institutional Venture Partners XV Executive Fund, L.P. 3000 SAND HILL ROAD, BLDG. 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001640274 Institutional Venture Partners XV, L.P. 3000 SAND HILL ROAD, BLDG. 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001553254 Maltz Jules A. 3000 SAND HILL ROAD, BLDG. 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001300134 Chaffee Todd C 3000 SAND HILL ROAD, BLDG. 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001843938 Dash Somesh 3000 SAND HILL ROAD, BLDG. 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001140932 FOGELSONG NORMAN A 3000 SAND HILL ROAD, BLDG. 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001299975 Harrick Stephen J 3000 SAND HILL ROAD, BLDG. 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001299965 Phelps Dennis B 3000 SAND HILL ROAD, BLDG. 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 0001359524 Miller J Sanford 3000 SAND HILL ROAD, BLDG. 2, SUITE 250 MENLO PARK CA 94025 0 0 1 0 Series B Preferred Stock 207232 I Directly held by Institutional Venture Partners XV, L.P. Series B Preferred Stock 1102 I Directly held by Institutional Venture Partners XV Executive Fund, L.P. Series B Preferred Stock 208383 I Directly held by Institutional Venture Partners XVI, L.P. Series A Preferred Stock Common Stock 3730160 I Directly held by Institutional Venture Partners XV, L.P. Series A Preferred Stock Common Stock 19843 I Directly held by Institutional Venture Partners XV Executive Fund, L.P. Series A Preferred Stock Common Stock 3749998 I Directly held by Institutional Venture Partners XVI, L.P. Institutional Venture Management XV, LLC ("IVM XV") is the general partner of Institutional Venture Partners XV, L.P. ("IVP XV"). Todd C. Chaffee, Somesh Dash, Norman A. Fogelsong, Stephen J. Harrick, Jules A. Maltz, J. Sanford Miller and Dennis B. Phelps (collectively, the "Managing Directors") and Eric Liaw are the managing directors of IVM XV and may be deemed to share voting and dispositive power over the shares held by IVP XV. Each of IVM XV and the Managing Directors disclaims beneficial ownership of these securities, except to the extent of its or his respective proportionate pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports. IVM XV is the general partner of Institutional Venture Partners XV Executive Fund, L.P. ("IVP XV-EF"). The Managing Directors and Eric Liaw are the managing directors of IVM XV and may be deemed to share voting and dispositive power over the shares held by IVP XV-EF. Each of IVM XV and the Managing Directors disclaims beneficial ownership of these securities, except to the extent of its or his respective proportionate pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports. Institutional Venture Management XVI, LLC ("IVM XVI") is the general partner of Institutional Venture Partners XVI, L.P. ("IVP XVI"). The Managing Directors and Eric Liaw are the managing directors of IVM XVI and may be deemed to share voting and dispositive power over the shares held by IVP XVI. Each of IVM XVI and the Managing Directors disclaims beneficial ownership of these securities, except to the extent of its or his respective proportionate pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports. Each share of Series A Preferred Stock will automatically convert into shares of Common Stock on a 1:4.79289 basis immediately prior to the closing of the Issuer's initial public offering and has no expiration date. 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 Management XVI, LLC. Exhibit 24 - Power of Attorney. /s/ Crystal Landsem, Attorney-in-Fact 2021-11-10 EX-24 2 attachment1.htm EX-24 DOCUMENT

                                                                      EXHIBIT 24

                                 POWER OF ATTORNEY

    With respect to holdings of and transactions in securities issued by Lulu's
Fashion Lounge Holdings, Inc. (the "Company"), the undersigned hereby
constitutes and appoints the individual or individuals named on Schedule A
attached hereto and as may be amended from time to time, or any of them signing
singly, with full power of substitution and resubstitution, to act as the
undersigned's true and lawful attorney-in-fact to:

    1.    prepare, execute in the undersigned's name and on the undersigned's
          behalf, and submit to the United States Securities and Exchange
          Commission (the "SEC") a Form ID, including amendments thereto, and
          any other documents necessary or appropriate to obtain and/or
          regenerate codes and passwords enabling the undersigned to make
          electronic filings with the SEC of reports required by Section 16(a)
          of the Securities Exchange Act of 1934, as amended, or any rule or
          regulation of the SEC;

    2.	  execute for and on behalf of the undersigned, Forms 3, 4, and 5 in
          accordance with Section 16 of the Securities Exchange Act of 1934, as
          amended, and the rules thereunder;

    3. 	  do and perform any and all acts for and on behalf of the undersigned
          which may be necessary or desirable to complete and execute any such
          Form 3, 4, or 5, complete and execute any amendment or amendments
          thereto, and timely file such form with the SEC and any stock exchange
          or similar authority; and

    4. 	  take any other action of any type whatsoever in connection with the
          foregoing which, in the opinion of such attorney-in-fact, may be of
          benefit to, in the best interest of, or legally required by, the
          undersigned, it being understood that the documents executed by such
          attorney-in-fact on behalf of the undersigned pursuant to this Power
          of Attorney shall be in such form and shall contain such terms and
          conditions as such attorney-in-fact may approve in such attorney-in-
          fact's discretion.

    The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution and
resubstitution or revocation, hereby ratifying and confirming all that such
attorney-in-fact, or such attorneys-in-fact substitute or substitutes, shall
lawfully do or cause to be done by virtue of this Power of Attorney and the
rights and powers herein granted.

    The undersigned acknowledges that the foregoing attorneys-in-fact, in
serving in such capacity at the request of the undersigned, are not assuming,
nor is the Company assuming, any of the undersigned's responsibilities to comply
with Section 16 of the Securities Exchange Act of 1934, as amended.

    This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.

    IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 10th day of November, 2021.


                                        Signature:   /s/ Eric Liaw
                                                     -------------
                                        Print Name:  Eric Liaw


                                     Schedule A

    Individual Appointed as Attorney-in-Fact with Full Power of Substitution and
Resubstitution

1.     David McCreight, Chief Executive Officer
2.     Crystal Landsem, Co-President and Chief Financial Officer