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 |
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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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Allbirds, Inc. [ BIRD ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 11/05/2021 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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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 | ||||||
Class A Common Stock | 11/05/2021 | C | 1,439,281 | A | $0.00 | 1,439,281 | D(1) | |||
Class A Common Stock | 11/05/2021 | S | 1,439,281 | D | $15 | 0 | D(1) | |||
Class A Common Stock | 11/05/2021 | C | 382,269 | A | $0.00 | 382,269 | D(2) | |||
Class A Common Stock | 11/05/2021 | S | 382,269 | D | $15 | 0 | D(2) | |||
Class A Common Stock | 11/05/2021 | C | 178,450 | A | $0.00 | 178,450 | D(3) | |||
Class A Common Stock | 11/05/2021 | S | 178,450 | D | $15 | 0 | D(3) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 | ||||||||
Series Seed Preferred Stock | (4) | 11/05/2021 | C | 290,625 | (4) | (4) | Class B Common Stock(5) | 290,625 | $0.00 | 0 | D(1) | ||||
Class B Common Stock | (5) | 11/05/2021 | C | 290,625 | (5) | (5) | Class A Common Stock | 290,625 | $0.00 | 393,785 | D(1) | ||||
Series A Preferred Stock | (4) | 11/05/2021 | C | 12,632,840 | (4) | (4) | Class B Common Stock(5) | 12,632,840 | $0.00 | 0 | D(1) | ||||
Class B Common Stock | (5) | 11/05/2021 | C | 12,632,840 | (5) | (5) | Class A Common Stock | 12,632,840 | $0.00 | 13,026,625 | D(1) | ||||
Class B Common Stock | (5) | 11/05/2021 | C | 1,439,281 | (5) | (5) | Class A Common Stock | 1,439,281 | $0.00 | 11,587,344 | D(1) | ||||
Series Seed Preferred Stock | (4) | 11/05/2021 | C | 29,165 | (4) | (4) | Class B Common Stock(5) | 29,165 | $0.00 | 0 | D(2) | ||||
Class B Common Stock | (5) | 11/05/2021 | C | 29,165 | (5) | (5) | Class A Common Stock | 29,165 | $0.00 | 39,520 | D(2) | ||||
Series A Preferred Stock | (4) | 11/05/2021 | C | 4,141,475 | (4) | (4) | Class B Common Stock(5) | 4,141,475 | $0.00 | 0 | D(2) | ||||
Class B Common Stock | (5) | 11/05/2021 | C | 4,141,475 | (5) | (5) | Class A Common Stock | 4,141,475 | $0.00 | 4,180,995 | D(2) | ||||
Class B Common Stock | (5) | 11/05/2021 | C | 382,269 | (5) | (5) | Class A Common Stock | 382,269 | $0.00 | 3,798,726 | D(2) | ||||
Series Seed Preferred Stock | (4) | 11/05/2021 | C | 35,925 | (4) | (4) | Class B Common Stock(5) | 35,925 | $0.00 | 0 | D(3) | ||||
Class B Common Stock | (5) | 11/05/2021 | C | 35,925 | (5) | (5) | Class A Common Stock | 35,925 | $0.00 | 48,680 | D(3) | ||||
Series A Preferred Stock | (4) | 11/05/2021 | C | 1,568,030 | (4) | (4) | Class B Common Stock(5) | 1,568,030 | $0.00 | 0 | D(3) | ||||
Class B Common Stock | (5) | 11/05/2021 | C | 1,568,030 | (5) | (5) | Class A Common Stock | 1,568,030 | $0.00 | 1,616,710 | D(3) | ||||
Class B Common Stock | (5) | 11/05/2021 | C | 178,450 | (5) | (5) | Class A Common Stock | 178,450 | $0.00 | 1,438,260 | D(3) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. Shares are held by Maveron Equity Partners V, L.P. Maveron General Partner V, LLC is the general partner of Maveron Equity Partners V, L.P. Dan Levitan, Pete McCormick, Jason Stoffer, and David Wu are the managing members of Maveron General Partner V, LLC and share voting and investment power over the shares held by Maveron Equity Partners V, L.P. |
2. Shares are held by MEP Associates V, L.P. Maveron General Partner V, LLC is the general partner of MEP Associates V, L.P. Dan Levitan, Pete McCormick, Jason Stoffer, and David Wu are the managing members of Maveron General Partner V, LLC and share voting and investment power over the shares held by MEP Associates V, L.P. |
3. Shares are held by Maveron V Entrepreneurs' Fund, L.P. Maveron General Partner V, LLC is the general partner of Maveron V Entrepreneurs' Fund, L.P. Dan Levitan, Pete McCormick, Jason Stoffer, and David Wu are the managing members of Maveron General Partner V, LLC and share voting and investment power over the shares held by Maveron V Entrepreneurs' Fund, L.P. |
4. Each share of Preferred Stock automatically converted into one share of Class B Common Stock immediately prior to the closing of the Issuer's initial public offering. |
5. Each share of Class B Common Stock is convertible at any time at the option of the Reporting Person into one share of Class A Common Stock and has no expiration date. Each share of Class B Common Stock held by the Reporting Person will convert automatically into one share of Class A Common Stock upon the sale or transfer of such share of Class B Common Stock, subject to certain exceptions, and in certain other circumstances described in the Issuer's amended and restated certificate of incorporation. |
Remarks: |
Maveron Equity Partners V, L.P., by Maveron General Partner V, LLC, its General Partner, by Dan Levitan, Managing Member, by /s/ Ron A. Metzger, Attorney-in-Fact | 11/08/2021 | |
MEP Associates V, L.P., by Maveron General Partner V, LLC, its General Partner, by Dan Levitan, Managing Member, by /s/ Ron A. Metzger, Attorney-in-Fact | 11/08/2021 | |
Maveron V Entrepreneurs' Fund, L.P., by Maveron General Partner V, LLC, its General Partner, by Dan Levitan, Managing Member, by /s/ Ron A. Metzger, Attorney-in-Fact | 11/08/2021 | |
Maveron General Partner V, LLC, by Dan Levitan, Managing Member, by /s/ Ron A. Metzger, Attorney-in-Fact | 11/08/2021 | |
** 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. |