Jeffrey D. Jordan - 21 Sep 2023 Form 4 Insider Report for Maplebear Inc. (CART)

Role
Director
Signature
/s/ Bradley Libuit, Attorney-in-fact
Issuer symbol
CART
Transactions as of
21 Sep 2023
Net transactions value
$0
Form type
4
Filing time
25 Sep 2023, 19:07:18 UTC
Previous filing
20 Sep 2023
Next filing
04 Oct 2023
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction CART Common Stock Conversion of derivative security +295,465 295,465 21 Sep 2023 By a16z Seed-III, LLC F1, F2, F3
transaction CART Common Stock Conversion of derivative security +4,713,103 4,713,103 21 Sep 2023 By AH Parallel Fund IV, L.P., as nominee F1, F3, F4
transaction CART Common Stock Conversion of derivative security +6,495,150 6,495,150 21 Sep 2023 By Andreessen Horowitz Fund IV, L.P., as nominee F1, F3, F5
transaction CART Common Stock Conversion of derivative security +465,014 465,014 21 Sep 2023 By Andreessen Horowitz LSV Fund I, L.P., as nominee F1, F3, F6
transaction CART Non-Voting Common Stock Other -20,783 -100% 0 21 Sep 2023 Direct F7
transaction CART Common Stock Other +20,783 20,783 21 Sep 2023 Direct F7

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction CART Series A Preferred Stock Conversion of derivative security $0 -295,465 -100% $0.000000* 0 21 Sep 2023 Common Stock 295,465 By a16z Seed-III, LLC F1, F2, F3
transaction CART Series B Preferred Stock Conversion of derivative security $0 -3,676,060 -100% $0.000000* 0 21 Sep 2023 Common Stock 3,766,368 By AH Parallel Fund IV, L.P., as nominee F1, F3, F4
transaction CART Series B Preferred Stock Conversion of derivative security $0 -5,066,000 -100% $0.000000* 0 21 Sep 2023 Common Stock 5,190,455 By Andreessen Horowitz Fund IV, L.P., as nominee F1, F3, F5
transaction CART Series C Preferred Stock Conversion of derivative security $0 -379,105 -100% $0.000000* 0 21 Sep 2023 Common Stock 379,105 By AH Parallel Fund IV, L.P., as nominee F1, F3, F4
transaction CART Series C Preferred Stock Conversion of derivative security $0 -522,440 -100% $0.000000* 0 21 Sep 2023 Common Stock 522,440 By Andreessen Horowitz Fund IV, L.P., as nominee F1, F3, F5
transaction CART Series D Preferred Stock Conversion of derivative security $0 -567,630 -100% $0.000000* 0 21 Sep 2023 Common Stock 567,630 By AH Parallel Fund IV, L.P., as nominee F1, F3, F4
transaction CART Series D Preferred Stock Conversion of derivative security $0 -782,255 -100% $0.000000* 0 21 Sep 2023 Common Stock 782,255 By Andreessen Horowitz Fund IV, L.P., as nominee F1, F3, F5
transaction CART Series D Preferred Stock Conversion of derivative security $0 -65,014 -100% $0.000000* 0 21 Sep 2023 Common Stock 65,014 By Andreessen Horowitz LSV Fund I, L.P., as nominee F1, F3, F6
transaction CART Series I Preferred Stock Conversion of derivative security $0 -400,000 -100% $0.000000* 0 21 Sep 2023 Common Stock 400,000 By Andreessen Horowitz LSV Fund I, L.P., as nominee F1, F3, F6
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Immediately prior to the closing of the Issuer's initial public offering, each share of Series A Preferred Stock, Series C Preferred Stock, Series D Preferred Stock and Series I Preferred Stock converted into shares of Common Stock on a 1:1 basis and each share of Series B Preferred Stock converted into shares of Common Stock on a 1.024566722:1 basis.
F2 The shares are held of record by a16z Seed-III, LLC.
F3 Mr. Jordan is a member of the general partners of the AH Fund Entities (as defined herein), but he disclaims the existence of a "group" and disclaims beneficial ownership of the shares held by the AH Fund Entities and this report shall not be deemed an admission that he is the beneficial owner of such shares, except to the extent of his pecuniary interest, if any, in such shares by virtue of his interest in the AH Fund Entities, and/or the general partner entities thereof, as applicable.
F4 The shares are held of record by AH Parallel Fund IV, L.P., for itself and as nominee for AH Parallel Fund IV-A, L.P., AH Parallel Fund IV-B, L.P. and AH Parallel Fund IV-Q, L.P. (collectively, the "AH Parallel Fund IV Entities"). AH Equity Partners IV (Parallel), L.L.C. ("AH EP IV Parallel") is the general partner of the AH Parallel Fund IV Entities and has sole voting and dispositive power with regard to the shares held by the AH Parallel Fund IV Entities. The managing members of AH EP IV Parallel are Marc Andreessen and Benjamin Horowitz. Marc Andreessen and Benjamin Horowitz share voting and dispositive power with respect to the shares held by the AH Parallel Fund IV Entities.
F5 The shares are held of record by Andreessen Horowitz Fund IV, L.P., for itself and as nominee for Andreessen Horowitz Fund IV-A, L.P., Andreessen Horowitz Fund IV-B, L.P. and Andreessen Horowitz Fund IV-Q, L.P. (collectively, the "AH Fund IV Entities"). AH Equity Partners IV, L.L.C. ("AH EP IV") is the general partner of the AH Fund IV Entities and has sole voting and dispositive power with regard to the shares held by the AH Fund IV Entities. The managing members of AH EP IV are Marc Andreessen and Benjamin Horowitz. Marc Andreessen and Benjamin Horowitz share voting and dispositive power with respect to the shares held by the AH Fund IV Entities.
F6 The shares are held of record by Andreessen Horowitz LSV Fund I, L.P., for itself and as nominee for Andreessen Horowitz LSV Fund I-B, L.P. and Andreessen Horowitz LSV Fund I-Q, L.P. (collectively, the "AH LSV Fund I Entities", and together with the AH Fund IV Entities, the AH Parallel Fund IV Entities and a16z Seed-III, LLC, the "AH Fund Entities"). AH Equity Partners LSV I, L.L.C. ("AH EP LSV I") is the general partner of the AH LSV Fund I Entities and has sole voting and dispositive power with regard to the shares held by the AH LSV Fund I Entities. The managing members of AH EP LSV I are Marc Andreessen and Benjamin Horowitz. Marc Andreessen and Benjamin Horowitz share voting and dispositive power with respect to the shares held by the AH LSV Fund I Entities.
F7 Each share of Non-Voting Common Stock was automatically converted into one share of Common Stock in connection with the closing of the Issuer's initial public offering of Common Stock.