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*
Furniturewala Mustafa S.

(Last) (First) (Middle)
381 E. EVELYN AVE.

(Street)
MOUNTAIN VIEW CA 94041

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/25/2022
3. Issuer Name and Ticker or Trading Symbol
Coursera, Inc. [ COUR ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP, Engineering
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)
Common Stock 187,339(1)(2)(3)(4) 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
Employee Stock Option (right to buy) (5) 08/29/2028 Common Stock 938 $2.23 D
Employee Stock Option (right to buy) (6) 04/07/2029 Common Stock 2,917 $5.66 D
Employee Stock Option (right to buy) (7) 08/27/2029 Common Stock 16,667 $6.3 D
Employee Stock Option (right to buy) (8) 02/19/2030 Common Stock 43,750 $7.06 D
Explanation of Responses:
1. Includes 42,900 shares issuable upon the settlement of a restricted stock unit ("RSU") award, with 25% of the award vesting on May 15, 2023, and 75% of the award vesting in 8 substantially equal quarterly installments thereafter, subject to the reporting person's continued service with the Issuer through the applicable vesting dates.
2. Includes 20,719 shares issuable upon the settlement of a RSU award, with 25% of the award vesting on August 15, 2022, and 75% of the award vesting in 12 substantially equal quarterly installments thereafter, subject to the reporting person's continued service with the Issuer through the applicable vesting dates.
3. Includes 91,604 shares issuable upon the settlement of a RSU award, with 25% of the award vesting on February 15, 2023, and 75% of the award vesting in 12 substantially equal quarterly installments thereafter, subject to the reporting person's continued service with the Issuer through the applicable vesting dates.
4. Includes 757 shares purchased under the Company's 2021 Employee Stock Purchase Plan on November 10, 2021.
5. Represents an initial option to purchase 5,000 shares of common stock, with 25% of the total number of shares subject to the option vesting on August 1, 2019, and 75% of the shares subject to the option vesting in 36 substantially equal monthly installments thereafter, subject to the reporting person's continued service with the Issuer through the applicable vesting dates.
6. Represents an initial option to purchase 10,000 shares of common stock, with 25% of the total number of shares subject to the option vesting on March 1, 2020, and 75% of the shares subject to the option vesting in 36 substantially equal monthly installments thereafter, subject to the reporting person's continued service with the Issuer through the applicable vesting dates.
7. Represents an initial option to purchase 40,000 shares of common stock, with 25% of the total number of shares subject to the option vesting on August 27, 2020, and 75% of the shares subject to the option vesting in 36 substantially equal monthly installments thereafter, subject to the reporting person's continued service with the Issuer through the applicable vesting dates.
8. Represents an initial option to purchase 100,000 shares of common stock, with 25% of the total number of shares subject to the option vesting on March 1, 2021, and 75% of the shares subject to the option vesting in 36 substantially equal monthly installments thereafter, subject to the reporting person's continued service with the Issuer through the applicable vesting dates.
Remarks:
Exhibit List: Exhibit 24 - Power of Attorney
By: /s/ Mustafa S. Furniturewala 08/03/2022
** 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.