0001835830-24-000008.txt : 20240216 0001835830-24-000008.hdr.sgml : 20240216 20240216165052 ACCESSION NUMBER: 0001835830-24-000008 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240215 FILED AS OF DATE: 20240216 DATE AS OF CHANGE: 20240216 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chaves Allen CENTRAL INDEX KEY: 0001991400 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41806 FILM NUMBER: 24649146 MAIL ADDRESS: STREET 1: KLAVIYO, INC. STREET 2: 125 SUMMER STREET, 6TH FLOOR CITY: BOSTON STATE: MA ZIP: 02110 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Klaviyo, Inc. CENTRAL INDEX KEY: 0001835830 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] ORGANIZATION NAME: 06 Technology IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 125 SUMMER STREET, FLOOR 6 CITY: BOSTON STATE: MA ZIP: 02110 BUSINESS PHONE: 800-338-1744 MAIL ADDRESS: STREET 1: 125 SUMMER STREET, FLOOR 6 CITY: BOSTON STATE: MA ZIP: 02110 4 1 wk-form4_1708120229.xml FORM 4 X0508 4 2024-02-15 0 0001835830 Klaviyo, Inc. KVYO 0001991400 Chaves Allen C/O KLAVIYO, INC. 125 SUMMER STREET 6TH FLOOR BOSTON MA 02110 0 1 0 0 Chief Technology Officer 0 Series A Common Stock 2024-02-15 4 C 0 9220 A 9220 D Series A Common Stock 2024-02-15 4 F 0 9220 29.71 D 0 D Series B Common Stock 2024-02-15 4 C 0 9220 0 D Series A Common Stock 9220 218746 D Represents 9,220 shares of Series B Common Stock, par value $0.001 per share ("Series B Common Stock"), automatically converted into Series A Common Stock, par value $0.001 per share ("Series A Common Stock") and subsequently withheld by the Issuer to satisfy tax withholding obligations in connection with the vesting and settlement of restricted stock units ("RSUs"). Each share of Series B Common Stock is convertible at any time at the option of the holder into one share of Series A Common Stock of the Issuer, and will automatically convert into Series A Common Stock upon the occurrence of certain events as set forth in the Issuer's certificate of incorporation. The Series B Common Stock has no expiration date. Amount consists of (a) 83,464 shares of Series B Common Stock and (b) 135,282 unvested RSUs awarded under the 2015 Stock Incentive Plan, each representing the contingent right to receive one share of Series B Common Stock upon vesting and settlement. /s/ Landon Edmond, Attorney-in-Fact 2024-02-16