0000899243-21-030067.txt : 20210726
0000899243-21-030067.hdr.sgml : 20210726
20210726213041
ACCESSION NUMBER: 0000899243-21-030067
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210726
FILED AS OF DATE: 20210726
DATE AS OF CHANGE: 20210726
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mayfield XIII, a Cayman Islands Exempted Limited Partnership
CENTRAL INDEX KEY: 0001573272
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40601
FILM NUMBER: 211115712
BUSINESS ADDRESS:
STREET 1: 2484 SAND HILL ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-854-5560
MAIL ADDRESS:
STREET 1: 2484 SAND HILL ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mayfield XIII Management (EGP), L.P., a Cayman Islands Exempted Limited Partnership
CENTRAL INDEX KEY: 0001573273
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40601
FILM NUMBER: 211115711
BUSINESS ADDRESS:
STREET 1: 2484 SAND HILL ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-854-5560
MAIL ADDRESS:
STREET 1: 2484 SAND HILL ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mayfield XIII Management (UGP), Ltd., a Cayman Islands Exempted Co.
CENTRAL INDEX KEY: 0001573274
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40601
FILM NUMBER: 211115710
BUSINESS ADDRESS:
STREET 1: 2484 SAND HILL ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-854-5560
MAIL ADDRESS:
STREET 1: 2484 SAND HILL ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
FORMER NAME:
FORMER CONFORMED NAME: Mayfield XIII Management (UGP), Ltd., a Cayman Islands Exempted Co
DATE OF NAME CHANGE: 20130328
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
2021-07-26
1
0001845022
Couchbase, Inc.
BASE
0001573272
Mayfield XIII, a Cayman Islands Exempted Limited Partnership
2484 SAND HILL ROAD
MENLO PARK
CA
94025
0
0
1
0
0001573273
Mayfield XIII Management (EGP), L.P., a Cayman Islands Exempted Limited Partnership
C/O MAYFIELD, 2484 SAND HILL ROAD
MENLO PARK
94025
0
0
1
0
0001573274
Mayfield XIII Management (UGP), Ltd., a Cayman Islands Exempted Co.
C/O MAYFIELD, 2484 SAND HILL ROAD
MENLO PARK
CA
94025
0
0
1
0
Common Stock
2021-07-26
4
C
0
3251435
A
3341480
I
Mayfield XIII, a Cayman Islands Exempted Limited Partnership
Series B Preferred Stock
2021-07-26
4
C
0
1909090
0.00
D
Common Stock
1909090
0
I
Mayfield XIII, a Cayman Islands Exempted Limited Partnership
Series C Preferred Stock
2021-07-26
4
C
0
715278
0.00
D
Common Stock
715278
0
I
Mayfield XIII, a Cayman Islands Exempted Limited Partnership
Series D Preferred Stock
2021-07-26
4
C
0
258017
0.00
D
Common Stock
258017
0
I
Mayfield XIII, a Cayman Islands Exempted Limited Partnership
Series E Preferred Stock
2021-07-26
4
C
0
120645
0.00
D
Common Stock
127014
0
I
Mayfield XIII, a Cayman Islands Exempted Limited Partnership
Series F Preferred Stock
2021-07-26
4
C
0
169212
0.00
D
Common Stock
169212
0
I
Mayfield XIII, a Cayman Islands Exempted Limited Partnership
Series G Preferred Stock
2021-07-26
4
C
0
68269
0.00
D
Common Stock
72824
0
I
Mayfield XIII, a Cayman Islands Exempted Limited Partnership
Immediately prior to the closing of the Issuer's initial public offering, each share of Series B Preferred Stock, Series C Preferred Stock, Series D Preferred Stock, and Series F Preferred Stock automatically converted into shares of the Issuer's Common Stock on a one-for-one basis, each share of Series E Preferred Stock automatically converted into shares of the Issuer's Common Stock on a 1.05279880234039-for-one basis, and each share of Series G Preferred Stock automatically converted into shares of the Issuer's Common Stock on a 1.06673317089756 basis. The preferred stock has no expiration date.
These shares are held of record by Mayfield XIII, a Cayman Islands Exempted Limited Partnership, or MF XIII. Mayfield XIII Management (UGP), Ltd., a Cayman Islands Exempted Company, or MF XIII UGP, is the general partner of Mayfield XIII Management (EGP), L.P., a Cayman Islands Exempted Limited Partnership, which is the general partner of MF XIII. Rajeev Batra, Navin Chaddha and Vaneeta Varma are the directors of MF XIII UGP. As a result, each of the foregoing entities and individuals may be deemed to share beneficial ownership of the shares owned by MF XIII, but each such entity or person disclaims such beneficial ownership except to the extent of its or their pecuniary interest therein.
Mayfield XIII, a Cayman Islands Exempted Limited Partnership, By: Mayfield XIII Management (EGP), L.P., its general partner, By: Mayfield XIII Management (UGP), Ltd., its general partner, By: /s/ Paul Kohli, Authorized Signatory
2021-07-26
Mayfield XIII Management (EGP), L.P., By: Mayfield XIII Management (UGP), Ltd., its general partner, By: /s/ Paul Kohli, Authorized Signatory
2021-07-26
Mayfield XIII Management (UGP), Ltd., By: /s/ Paul Kohli, Authorized Signatory
2021-07-26