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

Role
10%+ Owner
Signature
/s/ James H. Clark
Stock symbol
IBTA
Transactions as of
Apr 22, 2024
Transactions value $
$49,999,928
Form type
4
Date filed
4/22/2024, 04:06 PM
Previous filing
Apr 17, 2024

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction IBTA Common Stock Conversion of derivative security +5.76M 5.76M Apr 22, 2024 Direct F1, F2, F3, F4
transaction IBTA Common Stock Other -5.76M -100% 0 Apr 22, 2024 Direct F4, F5
transaction IBTA Class A Common Stock Other +5.76M 5.76M Apr 22, 2024 Direct F4, F5
transaction IBTA Class A Common Stock Purchase $50M +568K $88.00* 568K Apr 22, 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 -3.52M -100% 0 Apr 22, 2024 Common Stock 3.52M Direct F1
transaction IBTA Series C Preferred Stock Conversion of derivative security -1.86M -100% 0 Apr 22, 2024 Common Stock 1.86M Direct F2
transaction IBTA Series C-1 Preferred Stock Conversion of derivative security -379K -100% 0 Apr 22, 2024 Common Stock 379K 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.