Clark Jermoluk Founders Fund I LLC - 22 Apr 2024 Form 4 Insider Report for Ibotta, Inc. (IBTA)

Role
10%+ Owner
Signature
/s/ James H. Clark
Issuer symbol
IBTA
Transactions as of
22 Apr 2024
Net transactions value
+$49,999,928
Form type
4
Filing time
22 Apr 2024, 16:06:15 UTC
Previous filing
17 Apr 2024
Next filing
18 Dec 2025
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction IBTA Common Stock Conversion of derivative security +5,762,457 5,762,457 22 Apr 2024 Direct F1, F2, F3, F4
transaction IBTA Common Stock Other -5,762,457 -100% 0 22 Apr 2024 Direct F4, F5
transaction IBTA Class A Common Stock Other +5,762,457 5,762,457 22 Apr 2024 Direct F4, F5
transaction IBTA Class A Common Stock Purchase $49,999,928 +568,181 $88.00* 568,181 22 Apr 2024 See footnote F6

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 IBTA Series B Preferred Stock Conversion of derivative security -3,520,804 -100% 0 22 Apr 2024 Common Stock 3,520,804 Direct F1
transaction IBTA Series C Preferred Stock Conversion of derivative security -1,862,545 -100% 0 22 Apr 2024 Common Stock 1,862,545 Direct F2
transaction IBTA Series C-1 Preferred Stock Conversion of derivative security -379,108 -100% 0 22 Apr 2024 Common Stock 379,108 Direct F3
* 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 automatically converted 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 had no expiration date.
F2 Each share of Series C Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the IPO and had no expiration date.
F3 Each share of Series C-1 Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the IPO and had no expiration date.
F4 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.
F5 Pursuant to a reclassification exempt under Rule 16b-7, each share of Common Stock was automatically reclassified into one share of Class A Common Stock immediately prior to the completion of the IPO.
F6 The shares are held by Monaco Partners, L.P. ("Monaco Partners"). The general partner of Monaco Partners is Clark Ventures, which is wholly owned by the JHC Trust. The JHC Trust is an entity controlled by James H. Clark.