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

Source evidence Original filing metadata and source links for verification. 5 source fields
SEC form
4
Accepted by SEC
25 Sep 2023, 19:07:18 UTC
Prior SEC filing
20 Sep 2023
Next SEC filing
04 Oct 2023
Source filing
View source filing
Reporting owner 1 detail
Reporting owner signature
/s/ Bradley Libuit, Attorney-in-fact

Key filing fact

Jeffrey D. Jordan filed Form 4 for Maplebear Inc. (CART) on 25 Sep 2023.

Key facts

  • This page summarizes Jeffrey D. Jordan's Form 4 filing for Maplebear Inc. (CART).
  • 15 reported transactions and 9 derivative rows are listed below.
  • Accepted by SEC: 25 Sep 2023, 19:07.

Change

  • Previous filing in this sequence was filed on 20 Sep 2023.
  • Current net transaction value: $0.

Research use

  • This tells you what this filing adds before you inspect full transaction and derivative tables.
  • You can trace every row back to the original SEC filing document.

Evidence

Filed on Form 4

Ownership activity is grounded in SEC Form 4 disclosures.

View source filing

Reported non-derivative transactions

Shares, units, or other non-derivative securities reported in this filing.

CART transaction

Common Stock

Conversion of derivative security

Transaction value
Shares
+295,465
Change %
Price
Shares after
295,465
Date
21 Sep 2023
Ownership
By a16z Seed-III, LLC
Footnotes
F1, F2, F3
CART transaction

Common Stock

Conversion of derivative security

Transaction value
Shares
+4,713,103
Change %
Price
Shares after
4,713,103
Date
21 Sep 2023
Ownership
By AH Parallel Fund IV, L.P., as nominee
Footnotes
F1, F3, F4
CART transaction

Common Stock

Conversion of derivative security

Transaction value
Shares
+6,495,150
Change %
Price
Shares after
6,495,150
Date
21 Sep 2023
Ownership
By Andreessen Horowitz Fund IV, L.P., as nominee
Footnotes
F1, F3, F5
CART transaction

Common Stock

Conversion of derivative security

Transaction value
Shares
+465,014
Change %
Price
Shares after
465,014
Date
21 Sep 2023
Ownership
By Andreessen Horowitz LSV Fund I, L.P., as nominee
Footnotes
F1, F3, F6
CART transaction

Non-Voting Common Stock

Other

Transaction value
Shares
-20,783
Change %
-100%
Price
Shares after
0
Date
21 Sep 2023
Ownership
Direct
Footnotes
F7
CART transaction

Common Stock

Other

Transaction value
Shares
+20,783
Change %
Price
Shares after
20,783
Date
21 Sep 2023
Ownership
Direct
Footnotes
F7

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

CART transaction Derivative

Series A Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-295,465
Change %
-100%
Price
$0.000000*
Shares after
0
Date
21 Sep 2023
Ownership
By a16z Seed-III, LLC
Underlying class
Common Stock
Underlying amount
295,465
Exercise price
Footnotes
F1, F2, F3
CART transaction Derivative

Series B Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-3,676,060
Change %
-100%
Price
$0.000000*
Shares after
0
Date
21 Sep 2023
Ownership
By AH Parallel Fund IV, L.P., as nominee
Underlying class
Common Stock
Underlying amount
3,766,368
Exercise price
Footnotes
F1, F3, F4
CART transaction Derivative

Series B Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-5,066,000
Change %
-100%
Price
$0.000000*
Shares after
0
Date
21 Sep 2023
Ownership
By Andreessen Horowitz Fund IV, L.P., as nominee
Underlying class
Common Stock
Underlying amount
5,190,455
Exercise price
Footnotes
F1, F3, F5
CART transaction Derivative

Series C Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-379,105
Change %
-100%
Price
$0.000000*
Shares after
0
Date
21 Sep 2023
Ownership
By AH Parallel Fund IV, L.P., as nominee
Underlying class
Common Stock
Underlying amount
379,105
Exercise price
Footnotes
F1, F3, F4
CART transaction Derivative

Series C Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-522,440
Change %
-100%
Price
$0.000000*
Shares after
0
Date
21 Sep 2023
Ownership
By Andreessen Horowitz Fund IV, L.P., as nominee
Underlying class
Common Stock
Underlying amount
522,440
Exercise price
Footnotes
F1, F3, F5
CART transaction Derivative

Series D Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-567,630
Change %
-100%
Price
$0.000000*
Shares after
0
Date
21 Sep 2023
Ownership
By AH Parallel Fund IV, L.P., as nominee
Underlying class
Common Stock
Underlying amount
567,630
Exercise price
Footnotes
F1, F3, F4
CART transaction Derivative

Series D Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-782,255
Change %
-100%
Price
$0.000000*
Shares after
0
Date
21 Sep 2023
Ownership
By Andreessen Horowitz Fund IV, L.P., as nominee
Underlying class
Common Stock
Underlying amount
782,255
Exercise price
Footnotes
F1, F3, F5
CART transaction Derivative

Series D Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-65,014
Change %
-100%
Price
$0.000000*
Shares after
0
Date
21 Sep 2023
Ownership
By Andreessen Horowitz LSV Fund I, L.P., as nominee
Underlying class
Common Stock
Underlying amount
65,014
Exercise price
Footnotes
F1, F3, F6
CART transaction Derivative

Series I Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-400,000
Change %
-100%
Price
$0.000000*
Shares after
0
Date
21 Sep 2023
Ownership
By Andreessen Horowitz LSV Fund I, L.P., as nominee
Underlying class
Common Stock
Underlying amount
400,000
Exercise price
Footnotes
F1, F3, F6
* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 7 footnotes

Footnote 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.

Footnote F2

The shares are held of record by a16z Seed-III, LLC.

Footnote 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.

Footnote 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.

Footnote 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.

Footnote 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.

Footnote 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.

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