Clark Jermoluk Founders Fund I LLC - Apr 17, 2024 Form 3 Insider Report for Ibotta, Inc. (IBTA)

Role
10%+ Owner
Signature
/s/ James H. Clark
Stock symbol
IBTA
Transactions as of
Apr 17, 2024
Transactions value $
$0
Form type
3
Date filed
4/17/2024, 08:32 PM
Next filing
Apr 22, 2024

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
holding IBTA Series B Preferred Stock Apr 17, 2024 Common Stock 3.52M Direct F1, F2, F3
holding IBTA Series C Preferred Stock Apr 17, 2024 Common Stock 1.86M Direct F2, F3, F4
holding IBTA Series C-1 Preferred Stock Apr 17, 2024 Common Stock 379K Direct F2, F3, F5
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Each share of Series B Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock (the "IPO") and has no expiration date.
F2 Each share of Common Stock shall be reclassified into one share of Class A Common Stock immediately prior to the completion of the IPO.
F3 The shares are held by Clark Jermoluk Founders Fund I LLC, which is 95% owned by the JHC Family 2016 Trust (the "JHC Trust"). The JHC Trust is an entity controlled by James H. Clark.
F4 Each share of Series C Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the IPO and has no expiration date.
F5 Each share of Series C-1 Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the IPO and has no expiration date.