SEC Form 3
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*
Sumner Crystal

(Last) (First) (Middle)
415 KEARNY ST.

(Street)
SAN FRANCISCO CA 94108

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/15/2021
3. Issuer Name and Ticker or Trading Symbol
Blend Labs, Inc. [ BLND ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Head of Legal, Compliance,Risk
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
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)
Class A Common Stock(1) 396,346 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Stock Option (right to buy) (2) 08/21/2026 Class A Common Stock(1) 27,289 $0.54 D
Stock Option (right to buy) (2) 12/16/2028 Class A Common Stock(1) 160,000 $0.87 D
Stock Option (right to buy) (3) 03/28/2030 Class A Common Stock(1) 333,333 $2.31 D
Stock Option (right to buy) (4) 03/30/2031 Class A Common Stock(1) 200,000 $8.58 D
Stock Option (right to buy) (5) 03/30/2031 Class A Common Stock(1) 15,000 $8.58 D
Explanation of Responses:
1. Immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock, each share of Class A Common Stock as currently named will be reclassified into one share of Class B Common Stock and each share of Class B Common Stock as currently named will be reclassified into one share of Class A Common Stock. This Form 3 assumes all shares have been renamed as if such reclassification has already occurred.
2. The shares subject to this option are fully vested and immediately exercisable.
3. 1/48th of the shares subject to this option vest monthly following January 1, 2020, subject to the Reporting Person's continued role as a service provider to the Issuer. This option is subject to an early exercise provision and is immediately exercisable.
4. 1/24th of the shares subject to this option vest monthly following February 1, 2024, subject to the Reporting Person's continued role as a service provider to the Issuer. This option is subject to an early exercise provision and is immediately exercisable.
5. The shares subject to this option will be fully vested and exercisable on January 1. 2023. This option is subject to an early exercise provision and is immediately exercisable.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Crystal Sumner 07/15/2021
** 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.