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

Role
Director
Signature
/s/ Bradley Libuit, Attorney-in-fact
Stock symbol
CART
Transactions as of
Sep 21, 2023
Transactions value $
$0
Form type
4
Date filed
9/25/2023, 07:07 PM
Previous filing
Sep 18, 2023
Next filing
Oct 4, 2023

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction CART Common Stock Conversion of derivative security +295K 295K Sep 21, 2023 By a16z Seed-III, LLC F1, F2, F3
transaction CART Common Stock Conversion of derivative security +4.71M 4.71M Sep 21, 2023 By AH Parallel Fund IV, L.P., as nominee F1, F3, F4
transaction CART Common Stock Conversion of derivative security +6.5M 6.5M Sep 21, 2023 By Andreessen Horowitz Fund IV, L.P., as nominee F1, F3, F5
transaction CART Common Stock Conversion of derivative security +465K 465K Sep 21, 2023 By Andreessen Horowitz LSV Fund I, L.P., as nominee F1, F3, F6
transaction CART Non-Voting Common Stock Other -20.8K -100% 0 Sep 21, 2023 Direct F7
transaction CART Common Stock Other +20.8K 20.8K Sep 21, 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 -295K -100% $0.00* 0 Sep 21, 2023 Common Stock 295K By a16z Seed-III, LLC F1, F2, F3
transaction CART Series B Preferred Stock Conversion of derivative security $0 -3.68M -100% $0.00* 0 Sep 21, 2023 Common Stock 3.77M By AH Parallel Fund IV, L.P., as nominee F1, F3, F4
transaction CART Series B Preferred Stock Conversion of derivative security $0 -5.07M -100% $0.00* 0 Sep 21, 2023 Common Stock 5.19M By Andreessen Horowitz Fund IV, L.P., as nominee F1, F3, F5
transaction CART Series C Preferred Stock Conversion of derivative security $0 -379K -100% $0.00* 0 Sep 21, 2023 Common Stock 379K By AH Parallel Fund IV, L.P., as nominee F1, F3, F4
transaction CART Series C Preferred Stock Conversion of derivative security $0 -522K -100% $0.00* 0 Sep 21, 2023 Common Stock 522K By Andreessen Horowitz Fund IV, L.P., as nominee F1, F3, F5
transaction CART Series D Preferred Stock Conversion of derivative security $0 -568K -100% $0.00* 0 Sep 21, 2023 Common Stock 568K By AH Parallel Fund IV, L.P., as nominee F1, F3, F4
transaction CART Series D Preferred Stock Conversion of derivative security $0 -782K -100% $0.00* 0 Sep 21, 2023 Common Stock 782K By Andreessen Horowitz Fund IV, L.P., as nominee F1, F3, F5
transaction CART Series D Preferred Stock Conversion of derivative security $0 -65K -100% $0.00* 0 Sep 21, 2023 Common Stock 65K By Andreessen Horowitz LSV Fund I, L.P., as nominee F1, F3, F6
transaction CART Series I Preferred Stock Conversion of derivative security $0 -400K -100% $0.00* 0 Sep 21, 2023 Common Stock 400K 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.