09/17/2025 | Press release | Distributed by Public on 09/17/2025 14:26
FORM 4
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
EFRUSY KEVIN C/O COUCHBASE, INC. 3155 OLSEN DR., SUITE 150 SAN JOSE, CA 95117 |
X |
/s/ Margaret Chow, by Power of Attorney for Kevin Efrusy | 09/17/2025 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | This represents an award of restricted stock units to the Issuer's non-employee director. Each unit represents a contingent right to receive one share of the Issuer's common stock upon vesting. One hundred percent (100%) of the restricted stock units was scheduled to vest on September 15, 2025, but settlement has been deferred under our non-employee director RSU deferral program. |
(2) | Reflects distributions of (i) 423,600 shares of the Issuer's common stock, (ii) 423,600 shares of the Issuer's common stock, and (iii) 550,680 shares of the Issuer's common stock, in each case distributed by Accel X L.P. to its limited partners and general partner, which shares were further distributed, representing each such partner's pro rata interest in such shares distributed, for no consideration on December 18, 2023, January 8, 2024, and March 7, 2024, respectively, 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, 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, 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) | Reflects distributions of (i) 32,100 shares of the Issuer's common stock, (ii) 32,100 shares of the Issuer's common stock, and (iii) 41,730 shares of the Issuer's common stock, in each case distributed by Accel X Strategic Partners L.P. to its limited partners and general partner, which shares were further distributed, representing each such partner's pro rata interest in such shares distributed, for no consideration on December 18, 2023, January 8, 2024, and March 7, 2024, respectively, in accordance with the exemptions afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended. |
(5) | Reflects distributions of (i) 44,300 shares of the Issuer's common stock, (ii) 44,300 shares of the Issuer's common stock, and (iii) 57,590 shares of the Issuer's common stock, in each case distributed by Accel Investors 2008 L.L.C. to its limited partners and general partner, which shares were further distributed, representing each such partner's pro rata interest in such shares distributed, for no consideration on December 18, 2023, January 8, 2024, and March 7, 2024, respectively, in accordance with the exemptions afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended. |
(6) | Reflects distribution of (i) 476 shares of the Issuer's common stock by Accel X L.P. and (ii) 84 shares of the Issuer's common stock by Accel X Strategic Partners L.P., in each case distributed to A10A for no consideration on March 7, 2024, in accordance with the exemptions afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended. |
(7) | Reflects distributions of (i) 7,521 shares of the Issuer's common stock, (ii) 6,396 shares of the Issuer's common stock, and (iii) 210 shares of the Issuer's common stock, in each case distributed to The Efrusy Family Trust u/a/d 10/21/2005 (the "Trust"), of which Mr. Efrusy is a Trustee, for no consideration on December 18, 2023, January 8, 2024, and March 7, 2024, respectively, in accordance with the exemptions afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended. |
(8) | Shares held by the Trust. The Reporting Person disclaims beneficial ownership over the securities reported herein except to the extent of his pecuniary interest therein, if any, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities afforded by Rules 16a-13 and 16a-9 of the Securities Exchange Act of 1934, as amended. |