SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Accel X LP

(Last) (First) (Middle)
500 UNIVERSITY AVENUE

(Street)
PALO ALTO CA 94301

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Couchbase, Inc. [ BASE ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
03/13/2023
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 03/13/2023 J(1) 847,205 D $0.00 3,005,754 D
Common Stock 03/13/2023 J(2) 64,198 D $0.00 227,765 I By: Accel X Strategic Partners L.P.(3)
Common Stock 03/13/2023 J(4) 88,597 D $0.00 314,330 I By: Accel Investors 2008 L.L.C.(3)
Common Stock 2,022,312 I By: Accel Growth Fund II L.P.(3)
Common Stock 146,484 I By: Accel Growth Fund II Strategic Partners L.P.(3)
Common Stock 217,110 I By: Accel Growth Fund Investors 2013 L.L.C.(3)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
Accel X LP

(Last) (First) (Middle)
500 UNIVERSITY AVENUE

(Street)
PALO ALTO CA 94301

(City) (State) (Zip)
1. Name and Address of Reporting Person*
ACCEL X STRATEGIC PARTNERS LP

(Last) (First) (Middle)
500 UNIVERSITY AVENUE

(Street)
PALO ALTO CA 94301

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Accel X Associates L.L.C.

(Last) (First) (Middle)
500 UNIVERSITY AVENUE

(Street)
PALO ALTO CA 94301

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Accel Investors 2008 L.L.C.

(Last) (First) (Middle)
500 UNIVERSITY AVENUE

(Street)
PALO ALTO CA 94301

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Accel Growth Fund II L.P.

(Last) (First) (Middle)
500 UNIVERSITY AVENUE

(Street)
PALO ALTO CA 94301

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Accel Growth Fund II Strategic Partners L.P.

(Last) (First) (Middle)
500 UNIVERSITY AVENUE

(Street)
PALO ALTO CA 94301

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Accel Growth Fund II Associates L.L.C.

(Last) (First) (Middle)
500 UNIVERSITY AVENUE

(Street)
PALO ALTO CA 94301

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Accel Growth Fund Investors 2013 L.L.C.

(Last) (First) (Middle)
500 UNIVERSITY AVENUE

(Street)
PALO ALTO CA 94301

(City) (State) (Zip)
Explanation of Responses:
1. On March 13, 2023, Accel X LP distributed, for no consideration, 847,205 shares of Common Stock of the Issuer (the "Accel X LP Shares") to its limited partners and general partner, which shares were further distributed, representing each such partner's pro rata interest in such Accel X LP Shares. All of the aforementioned distributions were made in accordance with the exemptions afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended.
2. On March 13, 2023, Accel X Strategic Partners L.P. ("A10SP") distributed, for no consideration, 64,198 shares of Common Stock of the Issuer (the "A10SP Shares") to its limited partners and general partner, which shares were further distributed, representing each such partner's pro rata interest in such A10SP Shares. All of the aforementioned distributions were made in accordance with the exemptions afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended.
3. Accel X Associates L.L.C. ("A10A") is the General Partner of both Accel X L.P. and Accel X Strategic Partners L.P., and has the sole voting and investment power. Andrew G. Braccia, Kevin J. Efrusy, Sameer K. Gandhi, Ping Li, Tracy L. Sedlock and Richard P. Wong are the Managing Members of A10A and Accel Investors 2008 L.L.C., and therefore share the voting and investment powers. Accel Growth Fund II Associates L.L.C., or AGF2A, is the General Partner of both Accel Growth Fund II L.P. and Accel Growth Fund II Strategic Partners L.P., and has the sole voting and investment power. Andrew G. Braccia, Sameer K. Gandhi, Ping Li, Tracy L. Sedlock, Ryan J. Sweeney and Richard P. Wong are the Managing Members of AGF2A and Accel Growth Fund Investors 2013 L.L.C. and share such powers. Each person disclaims beneficial ownership except to the extent of their pecuniary interest therein. The address for all Accel entities listed above is 500 University Avenue, Palo Alto, California 94301.
4. On March 13, 2023, Accel Investors 2008 L.L.C. ("AI08") distributed for no consideration 88,597 shares of Common Stock of the Issuer (the "AI08 Shares") to its limited partners, representing each such partner's pro rata interest in such AI08 Shares. All of the aforementioned distributions were made in accordance with the exceptions afforded by Rules 16a-13 and 16a-9 of the Securities and Exchange Act of 1934, as amended.
Remarks:
/s/ Tracy L. Sedlock, as Attorney in Fact for Accel X L.P. 03/15/2023
/s/ Tracy L. Sedlock, as Attorney in Fact for Accel X Strategic Partners L.P. 03/15/2023
/s/ Tracy L. Sedlock, as Attorney in Fact for Accel X Associates L.L.C. 03/15/2023
/s/ Tracy L. Sedlock, as Attorney in Fact for Accel Investors 2008 L.L.C. 03/15/2023
/s/ Tracy L. Sedlock, as Attorney in Fact for Accel Growth Fund II L.P. 03/13/2023
/s/ Tracy L. Sedlock, as Attorney in Fact for Accel Growth Fund II Strategic Partners L.P. 03/15/2023
/s/ Tracy L. Sedlock, as Attorney in Fact for Accel Growth Fund II Associates L.L.C. 03/15/2023
/s/ Tracy L. Sedlock, as Attorney in Fact for Accel Growth Fund Investors 2013 L.L.C. 03/15/2023
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.