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person · Reporting owner

Kossow Jon Erik

Disclosed activity across 6 companies

Tapewire entity
114425
SEC CIK
0001726084

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Reported relationships

Latest disclosed role at each company.

CompanyLast reported asReport datePublished
Grove Collaborative Holdings, Inc.GROV · Entity 13510% ownerNovember 23, 2022April 17, 2023
IPI Legacy Liquidation CoIMPL · Entity 1565910% ownerApril 27, 2021April 29, 2021
Silk Road Medical IncSILK · Entity 8741710% ownerApril 08, 2019April 10, 2019

Disclosed balances

About these balances

Latest available filing per company, not a reconstructed current portfolio. Matching sequences show the last reported balance with all source rows expandable; grouping alone does not establish account ownership. Do not add unresolved positions together. Filings may omit unchanged positions, and amendments may correct only part of an older disclosure. Jointly reported shares are not necessarily this owner's personal holdings.

Grove Collaborative Holdings, Inc.

Report date November 23, 2022 · Filed April 17, 2023

Jointly reported with Norwest Venture Partners XIII, LP, NVP ASSOCIATES, LLC, Crowe Jeffrey, HAQUE PROMOD

Security / awardOwnership accountDisclosed shares / unitsDisclosure context
Class A Common StockSEC Table I · non-derivativeIndirectBy Norwest Venture Partners XIII, LP14,717,612 Reported balance After 2022-11-23 transaction · row 1 Joint disclosure: continuity of the reported position is unresolved; see ownership footnotes.
1 source row

Row 1 · 2022-11-23 · Conversion · Acquired 14,217,512 · Balance 14,717,612

F1: These shares of Class B common stock were converted into Class A common stock on a one-for-one basis for no additional consideration.

F2: The securities are directly held by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and NVP Associates, LLC ("NVP Associates") is the managing member of Genesis XIII. Genesis XIII, NVP Associates and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power over the shares held by NVP XIII. Each of Genesis XIII, NVP Associates and Messrs. Crowe, Haque and Kossow disclaims beneficial ownership of the securities held by NVP XIII except to the extent of its or his pecuniary interest therein.

Class B Common StockSEC Table II · derivative / convertible securityIndirectBy Norwest Venture Partners XIII, LP1,272,396 Reported balance After 2022-11-23 transaction · row 2 Instrument identity requires review; Table II rows are not merged.
1 source row

Row 2 · 2022-11-23 · Conversion · Disposed 14,217,512 · Balance 1,272,396

F1: These shares of Class B common stock were converted into Class A common stock on a one-for-one basis for no additional consideration.

F3: Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis for no additional consideration at the Reporting Person's election and has no expiration date.

F4: Represents restricted shares of Class B Common Stock that will vest upon the achievement of certain earnout thresholds prior to June 16, 2032 (the "Earnout Shares") as follows: (i) 50% of the Earnout Shares automatically vest if the daily volume weighted average price ("VWAP") of the shares of Class A Common Stock is greater than or equal to $12.50 per share for any 20 trading days within any 30-trading-day period; and (ii) 50% of the Earnout Shares automatically vest if the daily VWAP of the shares of Class A Common Stock is greater than or equal to $15.00 per share for any 20 trading days within any 30-trading-day period, each subject to certain change-of-control provisions.

F2: The securities are directly held by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and NVP Associates, LLC ("NVP Associates") is the managing member of Genesis XIII. Genesis XIII, NVP Associates and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power over the shares held by NVP XIII. Each of Genesis XIII, NVP Associates and Messrs. Crowe, Haque and Kossow disclaims beneficial ownership of the securities held by NVP XIII except to the extent of its or his pecuniary interest therein.

Class B Common StockSEC Table II · derivative / convertible securityIndirectBy Norwest Venture Partners XIII, LP1,407,876 Reported balance After 2023-04-13 transaction · row 3 Instrument identity requires review; Table II rows are not merged.
1 source row

Row 3 · 2023-04-13 · Other · Acquired 135,480 · Balance 1,407,876

F3: Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis for no additional consideration at the Reporting Person's election and has no expiration date.

F5: Represents the automatic increase, for no additional consideration, in the number of shares of Class B Common Stock held by the Reporting Person as a result of the rebalancing of Earnout Shares following the forfeiture of certain equity awards of the Issuer by the holders thereof, as required by the Agreement and Plan of Merger, dated December 7, 2021, as amended and restated on March 31, 2022, by and among Virgin Group Acquisition Corp. II ("VGAC II"), two wholly owned direct subsidiaries of VGAC II, and Grove Collaborative, Inc. This increase is exempt from Section 16 filing by virtue of the exemption provided by Rule 16a-9 and is being reported voluntarily.

F4: Represents restricted shares of Class B Common Stock that will vest upon the achievement of certain earnout thresholds prior to June 16, 2032 (the "Earnout Shares") as follows: (i) 50% of the Earnout Shares automatically vest if the daily volume weighted average price ("VWAP") of the shares of Class A Common Stock is greater than or equal to $12.50 per share for any 20 trading days within any 30-trading-day period; and (ii) 50% of the Earnout Shares automatically vest if the daily VWAP of the shares of Class A Common Stock is greater than or equal to $15.00 per share for any 20 trading days within any 30-trading-day period, each subject to certain change-of-control provisions.

F2: The securities are directly held by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and NVP Associates, LLC ("NVP Associates") is the managing member of Genesis XIII. Genesis XIII, NVP Associates and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power over the shares held by NVP XIII. Each of Genesis XIII, NVP Associates and Messrs. Crowe, Haque and Kossow disclaims beneficial ownership of the securities held by NVP XIII except to the extent of its or his pecuniary interest therein.

Filing footnotes · ownership attribution and instrument terms

F1: These shares of Class B common stock were converted into Class A common stock on a one-for-one basis for no additional consideration.

F2: The securities are directly held by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and NVP Associates, LLC ("NVP Associates") is the managing member of Genesis XIII. Genesis XIII, NVP Associates and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power over the shares held by NVP XIII. Each of Genesis XIII, NVP Associates and Messrs. Crowe, Haque and Kossow disclaims beneficial ownership of the securities held by NVP XIII except to the extent of its or his pecuniary interest therein.

F3: Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis for no additional consideration at the Reporting Person's election and has no expiration date.

F4: Represents restricted shares of Class B Common Stock that will vest upon the achievement of certain earnout thresholds prior to June 16, 2032 (the "Earnout Shares") as follows: (i) 50% of the Earnout Shares automatically vest if the daily volume weighted average price ("VWAP") of the shares of Class A Common Stock is greater than or equal to $12.50 per share for any 20 trading days within any 30-trading-day period; and (ii) 50% of the Earnout Shares automatically vest if the daily VWAP of the shares of Class A Common Stock is greater than or equal to $15.00 per share for any 20 trading days within any 30-trading-day period, each subject to certain change-of-control provisions.

F5: Represents the automatic increase, for no additional consideration, in the number of shares of Class B Common Stock held by the Reporting Person as a result of the rebalancing of Earnout Shares following the forfeiture of certain equity awards of the Issuer by the holders thereof, as required by the Agreement and Plan of Merger, dated December 7, 2021, as amended and restated on March 31, 2022, by and among Virgin Group Acquisition Corp. II ("VGAC II"), two wholly owned direct subsidiaries of VGAC II, and Grove Collaborative, Inc. This increase is exempt from Section 16 filing by virtue of the exemption provided by Rule 16a-9 and is being reported voluntarily.

IPI Legacy Liquidation Co

Report date April 27, 2021 · Filed April 29, 2021

Jointly reported with NORWEST VENTURE PARTNERS XIV, LP, Crowe Jeffrey, HAQUE PROMOD

Security / awardOwnership accountDisclosed shares / unitsDisclosure context
Common StockSEC Table I · non-derivativeDirect3,077,198 Last balance in matching sequence After 2021-04-27 transaction · row 3 Source-order balances reconcile. Account continuity and personal attribution are not independently verified.
3 source rows

Row 1 · 2021-04-27 · Conversion · Acquired 98,927 · Balance 98,927

F1: The securities shown represent securities held of record by Norwest Venture Partners XIV, LP ("NVP XIV"). Genesis VC Partners XIV, LLC ("Genesis XIV") is the general partner of NVP XIV and may be deemed to have sole voting and dispositive power over the shares held by NVP XIV. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIV, and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Messrs. Crowe, Haque and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Row 2 · 2021-04-27 · Conversion · Acquired 2,153,271 · Balance 2,252,198

F1: The securities shown represent securities held of record by Norwest Venture Partners XIV, LP ("NVP XIV"). Genesis VC Partners XIV, LLC ("Genesis XIV") is the general partner of NVP XIV and may be deemed to have sole voting and dispositive power over the shares held by NVP XIV. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIV, and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Messrs. Crowe, Haque and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F2: The shares of the Issuer's Series D Preferred Stock automatically converted into the number of shares of the Issuer's Common Stock on a 16.37332-for-one basis, for no additional consideration, immediately prior to the closing of the Issuer's initial public offering of Common Stock (the "IPO") and had no expiration date.

Row 3 · 2021-04-27 · Purchase · Acquired 825,000 · Balance 3,077,198

F1: The securities shown represent securities held of record by Norwest Venture Partners XIV, LP ("NVP XIV"). Genesis VC Partners XIV, LLC ("Genesis XIV") is the general partner of NVP XIV and may be deemed to have sole voting and dispositive power over the shares held by NVP XIV. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIV, and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Messrs. Crowe, Haque and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

5% Convertible Note due 2021SEC Table II · derivative / convertible security · Conversion / exercise price $13.50 · Expires 2021-12-31Direct0 Reported balance After 2021-04-27 transaction · row 4 Instrument identity requires review; Table II rows are not merged.
1 source row

Row 4 · 2021-04-27 · Conversion · Disposed Not disclosed · Balance 0

F1: The securities shown represent securities held of record by Norwest Venture Partners XIV, LP ("NVP XIV"). Genesis VC Partners XIV, LLC ("Genesis XIV") is the general partner of NVP XIV and may be deemed to have sole voting and dispositive power over the shares held by NVP XIV. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIV, and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Messrs. Crowe, Haque and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F3: The convertible promissory note was issued by the Issuer in March 2021 and the outstanding principal and accrued interest automatically converted into the number of shares of the Issuer's Common Stock set forth above upon the closing of the IPO at $13.50 per share (90% of the IPO price).

Series D Preferred StockSEC Table II · derivative / convertible securityDirect0 Reported balance After 2021-04-27 transaction · row 5 Instrument identity requires review; Table II rows are not merged.
1 source row

Row 5 · 2021-04-27 · Conversion · Disposed 35,256,206 · Balance 0

F1: The securities shown represent securities held of record by Norwest Venture Partners XIV, LP ("NVP XIV"). Genesis VC Partners XIV, LLC ("Genesis XIV") is the general partner of NVP XIV and may be deemed to have sole voting and dispositive power over the shares held by NVP XIV. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIV, and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Messrs. Crowe, Haque and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F2: The shares of the Issuer's Series D Preferred Stock automatically converted into the number of shares of the Issuer's Common Stock on a 16.37332-for-one basis, for no additional consideration, immediately prior to the closing of the Issuer's initial public offering of Common Stock (the "IPO") and had no expiration date.

Filing footnotes · ownership attribution and instrument terms

F1: The securities shown represent securities held of record by Norwest Venture Partners XIV, LP ("NVP XIV"). Genesis VC Partners XIV, LLC ("Genesis XIV") is the general partner of NVP XIV and may be deemed to have sole voting and dispositive power over the shares held by NVP XIV. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIV, and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Messrs. Crowe, Haque and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F2: The shares of the Issuer's Series D Preferred Stock automatically converted into the number of shares of the Issuer's Common Stock on a 16.37332-for-one basis, for no additional consideration, immediately prior to the closing of the Issuer's initial public offering of Common Stock (the "IPO") and had no expiration date.

F3: The convertible promissory note was issued by the Issuer in March 2021 and the outstanding principal and accrued interest automatically converted into the number of shares of the Issuer's Common Stock set forth above upon the closing of the IPO at $13.50 per share (90% of the IPO price).

Silk Road Medical Inc

Report date April 08, 2019 · Filed April 10, 2019

Jointly reported with Norwest Venture Partners XIII, LP, Crowe Jeffrey, HAQUE PROMOD

Security / awardOwnership accountDisclosed shares / unitsDisclosure context
Common StockSEC Table I · non-derivativeDirect2,461,974 Last balance in matching sequence After 2019-04-08 transaction · row 2 Source-order balances reconcile. Account continuity and personal attribution are not independently verified.
2 source rows

Row 1 · 2019-04-08 · Conversion · Acquired 2,458,210 · Balance 2,458,210

F1: The securities shown on Lines 1 and 2 of Table I and Lines 1 and 2 of Table II represent securities held of record by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and may be deemed to have sole voting and dispositive power over the shares held by NVP XIII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIII, and Promod Haque, Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Haque, Crowe, and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F2: The Series C 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 Common Stock and has no expiration date.

Row 2 · 2019-04-08 · Other · Acquired 3,764 · Balance 2,461,974

F1: The securities shown on Lines 1 and 2 of Table I and Lines 1 and 2 of Table II represent securities held of record by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and may be deemed to have sole voting and dispositive power over the shares held by NVP XIII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIII, and Promod Haque, Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Haque, Crowe, and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Series C Preferred StockSEC Table II · derivative / convertible securityDirect0 Reported balance After 2019-04-08 transaction · row 3 Instrument identity requires review; Table II rows are not merged.
1 source row

Row 3 · 2019-04-08 · Conversion · Disposed 2,458,210 · Balance 0

F1: The securities shown on Lines 1 and 2 of Table I and Lines 1 and 2 of Table II represent securities held of record by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and may be deemed to have sole voting and dispositive power over the shares held by NVP XIII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIII, and Promod Haque, Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Haque, Crowe, and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F2: The Series C 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 Common Stock and has no expiration date.

Warrant (Right to buy)SEC Table II · derivative / convertible security · Conversion / exercise price $8.27 · Expires 2024-12-21Direct0 Reported balance After 2019-04-08 transaction · row 4 Instrument identity requires review; Table II rows are not merged.
1 source row

Row 4 · 2019-04-08 · Other · Disposed 3,764 · Balance 0

F1: The securities shown on Lines 1 and 2 of Table I and Lines 1 and 2 of Table II represent securities held of record by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and may be deemed to have sole voting and dispositive power over the shares held by NVP XIII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIII, and Promod Haque, Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Haque, Crowe, and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F3: All of the shares subject to the warrant are fully exercisable as of the date hereof.

Filing footnotes · ownership attribution and instrument terms

F1: The securities shown on Lines 1 and 2 of Table I and Lines 1 and 2 of Table II represent securities held of record by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and may be deemed to have sole voting and dispositive power over the shares held by NVP XIII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIII, and Promod Haque, Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Haque, Crowe, and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F2: The Series C 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 Common Stock and has no expiration date.

F3: All of the shares subject to the warrant are fully exercisable as of the date hereof.

Past disclosures · reporting ended (3)

No longer tracked through insider filings. These historical balances do not imply present ownership or a zero position.

Health Catalyst, Inc.

Report date July 15, 2020 · Filed July 17, 2020

Jointly reported with NORWEST VENTURE PARTNERS XI, LP, Norwest Venture Partners XII, LP, Crowe Jeffrey

Section 16 reporting ended · disclosed 2020-07-17. Current position is not established by this disclosure.

Security / awardOwnership accountDisclosed shares / unitsDisclosure context
Common StockSEC Table I · non-derivativeDirect1,752,214 Reported balance After 2020-07-15 transaction · row 1 Joint disclosure: continuity of the reported position is unresolved; see ownership footnotes.
1 source row

Row 1 · 2020-07-15 · Other · Disposed 599,939 · Balance 1,752,214

F1: Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XI, LP ("NVP XI") to its limited partners.

F2: The NVP XI distribution resulted in a change in the form of beneficial ownership so that following the distribution 123 shares were beneficially owned by Kossow Family Trust, of which Mr. Kossow is a Trustee. The remaining 1,752,091 shares are held of record by NVP XI. Genesis VC Partners XI, LLC ("Genesis XI") is the general partner of NVP XI and may be deemed to have sole voting and dispositive power over the shares held by NVP XI. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XI, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Common StockSEC Table I · non-derivativeIndirectBy Limited Partnership1,752,090 Reported balance After 2020-07-15 transaction · row 2 Joint disclosure: continuity of the reported position is unresolved; see ownership footnotes.
1 source row

Row 2 · 2020-07-15 · Other · Disposed 600,000 · Balance 1,752,090

F3: Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XII, LP ("NVP XII") to its limited partners.

F4: The securities shown on Line 2 of Table I represent securities held of record by NVP XII. Genesis VC Partners XII, LLC ("Genesis XII") is the general partner of NVP XII and may be deemed to have sole voting and dispositive power over the shares held by NVP XII. NVP Associates, the managing member of Genesis XII, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Filing footnotes · ownership attribution and instrument terms

F1: Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XI, LP ("NVP XI") to its limited partners.

F2: The NVP XI distribution resulted in a change in the form of beneficial ownership so that following the distribution 123 shares were beneficially owned by Kossow Family Trust, of which Mr. Kossow is a Trustee. The remaining 1,752,091 shares are held of record by NVP XI. Genesis VC Partners XI, LLC ("Genesis XI") is the general partner of NVP XI and may be deemed to have sole voting and dispositive power over the shares held by NVP XI. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XI, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F3: Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XII, LP ("NVP XII") to its limited partners.

F4: The securities shown on Line 2 of Table I represent securities held of record by NVP XII. Genesis VC Partners XII, LLC ("Genesis XII") is the general partner of NVP XII and may be deemed to have sole voting and dispositive power over the shares held by NVP XII. NVP Associates, the managing member of Genesis XII, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

MOBILEIRON, INC.

Report date November 01, 2018 · Filed November 15, 2018

Jointly reported with NORWEST VENTURE PARTNERS X L P, HAQUE PROMOD, Crowe Jeffrey

Section 16 reporting ended · disclosed 2018-11-15. Current position is not established by this disclosure.

No balance rows disclosed in this filing.

Udemy, Inc.

Report date November 02, 2021 · Filed November 02, 2021

Jointly reported with Norwest Venture Partners XII, LP, NVP ASSOCIATES, LLC, HAQUE PROMOD, Crowe Jeffrey

Section 16 reporting ended · disclosed 2021-11-02. Current position is not established by this disclosure.

Security / awardOwnership accountDisclosed shares / unitsDisclosure context
Common StockSEC Table I · non-derivativeIndirectSee footnote12,458,934 Reported balance After 2021-11-02 transaction · row 1 Joint disclosure: continuity of the reported position is unresolved; see ownership footnotes.
1 source row

Row 1 · 2021-11-02 · Conversion · Acquired 11,552,940 · Balance 12,458,934

F1: Each share of Series C Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F2: Each share of Series D Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F3: The shares are held of record by Norwest Venture Partners XII, LP. Genesis VC Partners XII, LLC is the general partner of Norwest Venture Partners XII, LP, and NVP Associates, LLC is the managing member of Genesis VC Partners XII, LLC. Each of Promod Haque, Jeffrey Crowe, and Jon Kossow, who are co-chief executive officers of NVP Associates, LLC, may be deemed to share voting and dispositive power over the shares held by Norwest Venture Partners XII, LP. Each of the reporting entities and individuals disclaims beneficial ownership of the reported securities except to the extent of its or his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purpose.

Series C Convertible Preferred StockSEC Table II · derivative / convertible securityIndirectSee footnote0 Reported balance After 2021-11-02 transaction · row 2 Instrument identity requires review; Table II rows are not merged.
1 source row

Row 2 · 2021-11-02 · Conversion · Disposed 10,134,082 · Balance 0

F1: Each share of Series C Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F3: The shares are held of record by Norwest Venture Partners XII, LP. Genesis VC Partners XII, LLC is the general partner of Norwest Venture Partners XII, LP, and NVP Associates, LLC is the managing member of Genesis VC Partners XII, LLC. Each of Promod Haque, Jeffrey Crowe, and Jon Kossow, who are co-chief executive officers of NVP Associates, LLC, may be deemed to share voting and dispositive power over the shares held by Norwest Venture Partners XII, LP. Each of the reporting entities and individuals disclaims beneficial ownership of the reported securities except to the extent of its or his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purpose.

Series D Convertible Preferred StockSEC Table II · derivative / convertible securityIndirectSee footnote0 Reported balance After 2021-11-02 transaction · row 3 Instrument identity requires review; Table II rows are not merged.
1 source row

Row 3 · 2021-11-02 · Conversion · Disposed 1,418,858 · Balance 0

F2: Each share of Series D Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F3: The shares are held of record by Norwest Venture Partners XII, LP. Genesis VC Partners XII, LLC is the general partner of Norwest Venture Partners XII, LP, and NVP Associates, LLC is the managing member of Genesis VC Partners XII, LLC. Each of Promod Haque, Jeffrey Crowe, and Jon Kossow, who are co-chief executive officers of NVP Associates, LLC, may be deemed to share voting and dispositive power over the shares held by Norwest Venture Partners XII, LP. Each of the reporting entities and individuals disclaims beneficial ownership of the reported securities except to the extent of its or his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purpose.

Filing footnotes · ownership attribution and instrument terms

F1: Each share of Series C Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F2: Each share of Series D Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F3: The shares are held of record by Norwest Venture Partners XII, LP. Genesis VC Partners XII, LLC is the general partner of Norwest Venture Partners XII, LP, and NVP Associates, LLC is the managing member of Genesis VC Partners XII, LLC. Each of Promod Haque, Jeffrey Crowe, and Jon Kossow, who are co-chief executive officers of NVP Associates, LLC, may be deemed to share voting and dispositive power over the shares held by Norwest Venture Partners XII, LP. Each of the reporting entities and individuals disclaims beneficial ownership of the reported securities except to the extent of its or his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purpose.

Transaction history

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The cutoff filters transaction history only. Company summaries and owner relationships show the latest available disclosures. Parser corrections can improve historical records.

Transaction dateCompanyActivity / securityShares / unitsReported priceReported valueDetails
April 13, 2023 Filed Apr 17, 2023 21:18 UTC Grove Collaborative Holdings, Inc. GROV · Entity 135 OtherClass B Common Stock · Derivative 135,480 $0.00 $0.00
Disclosure

SEC source: 0001209191-23-024567 · doc4.xml · derivative · entry 3

Norwest Venture Partners XIII, LP · CIK 0001772583 · 10% owner

NVP Associates, LLC · CIK 0001545692 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: No plan indicated

Ownership: Indirect · By Norwest Venture Partners XIII, LP

Disclosed balance after: 1,407,876

Underlying: Class A Common Stock · 135,480 shares

Expires not disclosed

F3 · derivative.exercise_price: Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis for no additional consideration at the Reporting Person's election and has no expiration date.

F5 · kind: Represents the automatic increase, for no additional consideration, in the number of shares of Class B Common Stock held by the Reporting Person as a result of the rebalancing of Earnout Shares following the forfeiture of certain equity awards of the Issuer by the holders thereof, as required by the Agreement and Plan of Merger, dated December 7, 2021, as amended and restated on March 31, 2022, by and among Virgin Group Acquisition Corp. II ("VGAC II"), two wholly owned direct subsidiaries of VGAC II, and Grove Collaborative, Inc. This increase is exempt from Section 16 filing by virtue of the exemption provided by Rule 16a-9 and is being reported voluntarily.

F3 · price: Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis for no additional consideration at the Reporting Person's election and has no expiration date.

F3 · derivative.exercise_date: Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis for no additional consideration at the Reporting Person's election and has no expiration date.

F3 · derivative.expiration_date: Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis for no additional consideration at the Reporting Person's election and has no expiration date.

F4 · balance_after: Represents restricted shares of Class B Common Stock that will vest upon the achievement of certain earnout thresholds prior to June 16, 2032 (the "Earnout Shares") as follows: (i) 50% of the Earnout Shares automatically vest if the daily volume weighted average price ("VWAP") of the shares of Class A Common Stock is greater than or equal to $12.50 per share for any 20 trading days within any 30-trading-day period; and (ii) 50% of the Earnout Shares automatically vest if the daily VWAP of the shares of Class A Common Stock is greater than or equal to $15.00 per share for any 20 trading days within any 30-trading-day period, each subject to certain change-of-control provisions.

F2 · ownership.nature: The securities are directly held by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and NVP Associates, LLC ("NVP Associates") is the managing member of Genesis XIII. Genesis XIII, NVP Associates and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power over the shares held by NVP XIII. Each of Genesis XIII, NVP Associates and Messrs. Crowe, Haque and Kossow disclaims beneficial ownership of the securities held by NVP XIII except to the extent of its or his pecuniary interest therein.

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November 23, 2022 Filed Apr 17, 2023 21:18 UTC Grove Collaborative Holdings, Inc. GROV · Entity 135 ConversionClass B Common Stock · Derivative 14,217,512 $0.00 $0.00
Disclosure

SEC source: 0001209191-23-024567 · doc4.xml · derivative · entry 2

Norwest Venture Partners XIII, LP · CIK 0001772583 · 10% owner

NVP Associates, LLC · CIK 0001545692 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: No plan indicated

Ownership: Indirect · By Norwest Venture Partners XIII, LP

Disclosed balance after: 1,272,396

Underlying: Class A Common Stock · 14,217,512 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · derivative.exercise_price: These shares of Class B common stock were converted into Class A common stock on a one-for-one basis for no additional consideration.

F3 · price: Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis for no additional consideration at the Reporting Person's election and has no expiration date.

F3 · derivative.exercise_date: Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis for no additional consideration at the Reporting Person's election and has no expiration date.

F3 · derivative.expiration_date: Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis for no additional consideration at the Reporting Person's election and has no expiration date.

F4 · balance_after: Represents restricted shares of Class B Common Stock that will vest upon the achievement of certain earnout thresholds prior to June 16, 2032 (the "Earnout Shares") as follows: (i) 50% of the Earnout Shares automatically vest if the daily volume weighted average price ("VWAP") of the shares of Class A Common Stock is greater than or equal to $12.50 per share for any 20 trading days within any 30-trading-day period; and (ii) 50% of the Earnout Shares automatically vest if the daily VWAP of the shares of Class A Common Stock is greater than or equal to $15.00 per share for any 20 trading days within any 30-trading-day period, each subject to certain change-of-control provisions.

F2 · ownership.nature: The securities are directly held by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and NVP Associates, LLC ("NVP Associates") is the managing member of Genesis XIII. Genesis XIII, NVP Associates and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power over the shares held by NVP XIII. Each of Genesis XIII, NVP Associates and Messrs. Crowe, Haque and Kossow disclaims beneficial ownership of the securities held by NVP XIII except to the extent of its or his pecuniary interest therein.

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November 23, 2022 Filed Apr 17, 2023 21:18 UTC Grove Collaborative Holdings, Inc. GROV · Entity 135 ConversionClass A Common Stock 14,217,512 $0.00 $0.00
Disclosure

SEC source: 0001209191-23-024567 · doc4.xml · nonDerivative · entry 1

Norwest Venture Partners XIII, LP · CIK 0001772583 · 10% owner

NVP Associates, LLC · CIK 0001545692 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: No plan indicated

Ownership: Indirect · By Norwest Venture Partners XIII, LP

Disclosed balance after: 14,717,612

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · price: These shares of Class B common stock were converted into Class A common stock on a one-for-one basis for no additional consideration.

F2 · ownership.nature: The securities are directly held by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and NVP Associates, LLC ("NVP Associates") is the managing member of Genesis XIII. Genesis XIII, NVP Associates and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power over the shares held by NVP XIII. Each of Genesis XIII, NVP Associates and Messrs. Crowe, Haque and Kossow disclaims beneficial ownership of the securities held by NVP XIII except to the extent of its or his pecuniary interest therein.

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November 02, 2021 Filed Nov 2, 2021 19:00 UTC Udemy, Inc. UDMY · Entity 47614 ConversionSeries D Convertible Preferred Stock · Derivative 1,418,858 Not disclosed Not disclosed
Disclosure

SEC source: 0000899243-21-042450 · doc4.xml · derivative · entry 3

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

NVP Associates, LLC · CIK 0001545692 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Indirect · See footnote

Disclosed balance after: 0

Underlying: Common Stock · 1,418,858 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F2 · derivative.exercise_price: Each share of Series D Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F2 · price: Each share of Series D Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F2 · derivative.exercise_date: Each share of Series D Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F2 · derivative.expiration_date: Each share of Series D Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F3 · ownership.nature: The shares are held of record by Norwest Venture Partners XII, LP. Genesis VC Partners XII, LLC is the general partner of Norwest Venture Partners XII, LP, and NVP Associates, LLC is the managing member of Genesis VC Partners XII, LLC. Each of Promod Haque, Jeffrey Crowe, and Jon Kossow, who are co-chief executive officers of NVP Associates, LLC, may be deemed to share voting and dispositive power over the shares held by Norwest Venture Partners XII, LP. Each of the reporting entities and individuals disclaims beneficial ownership of the reported securities except to the extent of its or his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purpose.

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November 02, 2021 Filed Nov 2, 2021 19:00 UTC Udemy, Inc. UDMY · Entity 47614 ConversionSeries C Convertible Preferred Stock · Derivative 10,134,082 Not disclosed Not disclosed
Disclosure

SEC source: 0000899243-21-042450 · doc4.xml · derivative · entry 2

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

NVP Associates, LLC · CIK 0001545692 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Indirect · See footnote

Disclosed balance after: 0

Underlying: Common Stock · 10,134,082 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · derivative.exercise_price: Each share of Series C Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F1 · price: Each share of Series C Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F1 · derivative.exercise_date: Each share of Series C Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F1 · derivative.expiration_date: Each share of Series C Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F3 · ownership.nature: The shares are held of record by Norwest Venture Partners XII, LP. Genesis VC Partners XII, LLC is the general partner of Norwest Venture Partners XII, LP, and NVP Associates, LLC is the managing member of Genesis VC Partners XII, LLC. Each of Promod Haque, Jeffrey Crowe, and Jon Kossow, who are co-chief executive officers of NVP Associates, LLC, may be deemed to share voting and dispositive power over the shares held by Norwest Venture Partners XII, LP. Each of the reporting entities and individuals disclaims beneficial ownership of the reported securities except to the extent of its or his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purpose.

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November 02, 2021 Filed Nov 2, 2021 19:00 UTC Udemy, Inc. UDMY · Entity 47614 ConversionCommon Stock 11,552,940 Not disclosed Not disclosed
Disclosure

SEC source: 0000899243-21-042450 · doc4.xml · nonDerivative · entry 1

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

NVP Associates, LLC · CIK 0001545692 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Indirect · See footnote

Disclosed balance after: 12,458,934

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · price: Each share of Series C Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F2 · price: Each share of Series D Convertible Preferred Stock automatically converted into Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

F3 · ownership.nature: The shares are held of record by Norwest Venture Partners XII, LP. Genesis VC Partners XII, LLC is the general partner of Norwest Venture Partners XII, LP, and NVP Associates, LLC is the managing member of Genesis VC Partners XII, LLC. Each of Promod Haque, Jeffrey Crowe, and Jon Kossow, who are co-chief executive officers of NVP Associates, LLC, may be deemed to share voting and dispositive power over the shares held by Norwest Venture Partners XII, LP. Each of the reporting entities and individuals disclaims beneficial ownership of the reported securities except to the extent of its or his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purpose.

Read SEC document
April 27, 2021 Filed Apr 29, 2021 19:45 UTC IPI Legacy Liquidation Co IMPL · Entity 15659 ConversionSeries D Preferred Stock · Derivative 35,256,206 $0.00 $0.00
Disclosure

SEC source: 0001209191-21-029115 · doc4.xml · derivative · entry 5

Norwest Venture Partners XIV, LP · CIK 0001842721 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 0

Underlying: Common Stock · 2,153,271 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · security: The securities shown represent securities held of record by Norwest Venture Partners XIV, LP ("NVP XIV"). Genesis VC Partners XIV, LLC ("Genesis XIV") is the general partner of NVP XIV and may be deemed to have sole voting and dispositive power over the shares held by NVP XIV. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIV, and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Messrs. Crowe, Haque and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F2 · derivative.exercise_price: The shares of the Issuer's Series D Preferred Stock automatically converted into the number of shares of the Issuer's Common Stock on a 16.37332-for-one basis, for no additional consideration, immediately prior to the closing of the Issuer's initial public offering of Common Stock (the "IPO") and had no expiration date.

F2 · derivative.exercise_date: The shares of the Issuer's Series D Preferred Stock automatically converted into the number of shares of the Issuer's Common Stock on a 16.37332-for-one basis, for no additional consideration, immediately prior to the closing of the Issuer's initial public offering of Common Stock (the "IPO") and had no expiration date.

F2 · derivative.expiration_date: The shares of the Issuer's Series D Preferred Stock automatically converted into the number of shares of the Issuer's Common Stock on a 16.37332-for-one basis, for no additional consideration, immediately prior to the closing of the Issuer's initial public offering of Common Stock (the "IPO") and had no expiration date.

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April 27, 2021 Filed Apr 29, 2021 19:45 UTC IPI Legacy Liquidation Co IMPL · Entity 15659 Conversion5% Convertible Note due 2021 · Derivative Not disclosed $0.00 Strike: $13.50 $1,325,893.04
Disclosure

SEC source: 0001209191-21-029115 · doc4.xml · derivative · entry 4

Norwest Venture Partners XIV, LP · CIK 0001842721 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 0

Underlying: Common Stock · 98,927 shares

Expires 2021-12-31

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · security: The securities shown represent securities held of record by Norwest Venture Partners XIV, LP ("NVP XIV"). Genesis VC Partners XIV, LLC ("Genesis XIV") is the general partner of NVP XIV and may be deemed to have sole voting and dispositive power over the shares held by NVP XIV. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIV, and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Messrs. Crowe, Haque and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F3 · derivative.exercise_price: The convertible promissory note was issued by the Issuer in March 2021 and the outstanding principal and accrued interest automatically converted into the number of shares of the Issuer's Common Stock set forth above upon the closing of the IPO at $13.50 per share (90% of the IPO price).

F3 · derivative.exercise_date: The convertible promissory note was issued by the Issuer in March 2021 and the outstanding principal and accrued interest automatically converted into the number of shares of the Issuer's Common Stock set forth above upon the closing of the IPO at $13.50 per share (90% of the IPO price).

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April 27, 2021 Filed Apr 29, 2021 19:45 UTC IPI Legacy Liquidation Co IMPL · Entity 15659 PurchaseCommon Stock 825,000 $15.00 $12,375,000.00
Disclosure

SEC source: 0001209191-21-029115 · doc4.xml · nonDerivative · entry 3

Norwest Venture Partners XIV, LP · CIK 0001842721 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 3,077,198

F1 · security: The securities shown represent securities held of record by Norwest Venture Partners XIV, LP ("NVP XIV"). Genesis VC Partners XIV, LLC ("Genesis XIV") is the general partner of NVP XIV and may be deemed to have sole voting and dispositive power over the shares held by NVP XIV. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIV, and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Messrs. Crowe, Haque and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Read SEC document
April 27, 2021 Filed Apr 29, 2021 19:45 UTC IPI Legacy Liquidation Co IMPL · Entity 15659 ConversionCommon Stock 2,153,271 $0.00 $0.00
Disclosure

SEC source: 0001209191-21-029115 · doc4.xml · nonDerivative · entry 2

Norwest Venture Partners XIV, LP · CIK 0001842721 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 2,252,198

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · security: The securities shown represent securities held of record by Norwest Venture Partners XIV, LP ("NVP XIV"). Genesis VC Partners XIV, LLC ("Genesis XIV") is the general partner of NVP XIV and may be deemed to have sole voting and dispositive power over the shares held by NVP XIV. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIV, and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Messrs. Crowe, Haque and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F2 · price: The shares of the Issuer's Series D Preferred Stock automatically converted into the number of shares of the Issuer's Common Stock on a 16.37332-for-one basis, for no additional consideration, immediately prior to the closing of the Issuer's initial public offering of Common Stock (the "IPO") and had no expiration date.

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April 27, 2021 Filed Apr 29, 2021 19:45 UTC IPI Legacy Liquidation Co IMPL · Entity 15659 ConversionCommon Stock 98,927 $13.50 $1,335,514.50
Disclosure

SEC source: 0001209191-21-029115 · doc4.xml · nonDerivative · entry 1

Norwest Venture Partners XIV, LP · CIK 0001842721 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 98,927

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · security: The securities shown represent securities held of record by Norwest Venture Partners XIV, LP ("NVP XIV"). Genesis VC Partners XIV, LLC ("Genesis XIV") is the general partner of NVP XIV and may be deemed to have sole voting and dispositive power over the shares held by NVP XIV. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIV, and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Messrs. Crowe, Haque and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Read SEC document
April 22, 2021 Filed Apr 26, 2021 19:02 UTC IPI Legacy Liquidation Co IMPL · Entity 15659 Other5% Convertible Note due 2021 · Derivative Not disclosed $0.00 $1,325,893.04
Disclosure

SEC source: 0001209191-21-028401 · doc4.xml · derivative · entry 1

Norwest Venture Partners XIV, LP · CIK 0001842721 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: Not disclosed

Underlying: Common Stock · 98,927 shares

Expires 2021-12-31

F1 · derivative.exercise_price: The convertible promissory note was issued by the issuer in March 2021 and the outstanding principal and accrued interest will automatically convert into the number of shares of the issuer's Common Stock set forth above upon the closing of the issuer's initial public offering (the "IPO") at $13.50 per share (90% of the IPO price). The conversion price became fixed upon pricing of the issuer's IPO on April 22, 2021.

F1 · derivative.exercise_date: The convertible promissory note was issued by the issuer in March 2021 and the outstanding principal and accrued interest will automatically convert into the number of shares of the issuer's Common Stock set forth above upon the closing of the issuer's initial public offering (the "IPO") at $13.50 per share (90% of the IPO price). The conversion price became fixed upon pricing of the issuer's IPO on April 22, 2021.

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July 15, 2020 Filed Jul 17, 2020 18:00 UTC Health Catalyst, Inc. HCAT · Entity 1565 OtherCommon Stock 600,000 $0.00 $0.00
Disclosure

SEC source: 0001209191-20-042940 · doc4.xml · nonDerivative · entry 2

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Indirect · By Limited Partnership

Disclosed balance after: 1,752,090

F3 · kind: Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XII, LP ("NVP XII") to its limited partners.

F3 · price: Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XII, LP ("NVP XII") to its limited partners.

F4 · ownership.nature: The securities shown on Line 2 of Table I represent securities held of record by NVP XII. Genesis VC Partners XII, LLC ("Genesis XII") is the general partner of NVP XII and may be deemed to have sole voting and dispositive power over the shares held by NVP XII. NVP Associates, the managing member of Genesis XII, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

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July 15, 2020 Filed Jul 17, 2020 18:00 UTC Health Catalyst, Inc. HCAT · Entity 1565 OtherCommon Stock 599,939 $0.00 $0.00
Disclosure

SEC source: 0001209191-20-042940 · doc4.xml · nonDerivative · entry 1

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 1,752,214

F1 · kind: Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XI, LP ("NVP XI") to its limited partners.

F1 · price: Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XI, LP ("NVP XI") to its limited partners.

F2 · balance_after: The NVP XI distribution resulted in a change in the form of beneficial ownership so that following the distribution 123 shares were beneficially owned by Kossow Family Trust, of which Mr. Kossow is a Trustee. The remaining 1,752,091 shares are held of record by NVP XI. Genesis VC Partners XI, LLC ("Genesis XI") is the general partner of NVP XI and may be deemed to have sole voting and dispositive power over the shares held by NVP XI. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XI, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Read SEC document
January 21, 2020 Filed Jan 23, 2020 17:30 UTC Health Catalyst, Inc. HCAT · Entity 1565 OtherCommon Stock 600,000 $0.00 $0.00
Disclosure

SEC source: 0001209191-20-004714 · doc4.xml · nonDerivative · entry 2

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Indirect · By Limited Partnership

Disclosed balance after: 2,352,090

F3 · kind: Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XII, LP ("NVP XII") to its limited partners.

F3 · price: Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XII, LP ("NVP XII") to its limited partners.

F4 · ownership.nature: The securities shown on Line 2 of Table I represent securities held of record by NVP XII. Genesis VC Partners XII, LLC ("Genesis XII") is the general partner of NVP XII and may be deemed to have sole voting and dispositive power over the shares held by NVP XII. NVP Associates, the managing member of Genesis XII, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Read SEC document
January 21, 2020 Filed Jan 23, 2020 17:30 UTC Health Catalyst, Inc. HCAT · Entity 1565 OtherCommon Stock 599,938 $0.00 $0.00
Disclosure

SEC source: 0001209191-20-004714 · doc4.xml · nonDerivative · entry 1

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 2,352,153

F1 · kind: Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XI, LP ("NVP XI") to its limited partners.

F1 · price: Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XI, LP ("NVP XI") to its limited partners.

F2 · balance_after: The NVP XI distribution resulted in a change in the form of beneficial ownership so that following the distribution 62 shares were beneficially owned by Kossow Family Trust, of which Mr. Kossow is a Trustee. The remaining 2,352,091 shares are held of record by NVP XI. Genesis VC Partners XI, LLC ("Genesis XI") is the general partner of NVP XI and may be deemed to have sole voting and dispositive power over the shares held by NVP XI. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XI, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Read SEC document
July 29, 2019 Filed Jul 29, 2019 21:02 UTC Health Catalyst, Inc. HCAT · Entity 1565 ConversionSeries F Convertible Preferred Stock · Derivative 35,919 $0.00 $0.00
Disclosure

SEC source: 0001209191-19-043590 · doc4.xml · derivative · entry 12

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Indirect · By Limited Partnership

Disclosed balance after: 0

Underlying: Common Stock · 35,919 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F6 · derivative.exercise_price: The Series F Convertible 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 Common Stock and has no expiration date.

F6 · derivative.exercise_date: The Series F Convertible 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 Common Stock and has no expiration date.

F6 · derivative.expiration_date: The Series F Convertible 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 Common Stock and has no expiration date.

F7 · ownership.nature: The securities shown on Line 2 of Table I and Lines 6 through 10 of Table II represent securities held of record by Norwest Venture Partners XII, LP ("NVP XII"). Genesis VC Partners XII, LLC ("Genesis XII") is the general partner of NVP XII and may be deemed to have sole voting and dispositive power over the shares held by NVP XII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XII, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Read SEC document
July 29, 2019 Filed Jul 29, 2019 21:02 UTC Health Catalyst, Inc. HCAT · Entity 1565 ConversionSeries E Convertible Preferred Stock · Derivative 424,568 $0.00 $0.00
Disclosure

SEC source: 0001209191-19-043590 · doc4.xml · derivative · entry 11

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Indirect · By Limited Partnership

Disclosed balance after: 0

Underlying: Common Stock · 424,568 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F5 · derivative.exercise_price: The Series E Convertible 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 Common Stock and has no expiration date.

F5 · derivative.exercise_date: The Series E Convertible 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 Common Stock and has no expiration date.

F5 · derivative.expiration_date: The Series E Convertible 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 Common Stock and has no expiration date.

F7 · ownership.nature: The securities shown on Line 2 of Table I and Lines 6 through 10 of Table II represent securities held of record by Norwest Venture Partners XII, LP ("NVP XII"). Genesis VC Partners XII, LLC ("Genesis XII") is the general partner of NVP XII and may be deemed to have sole voting and dispositive power over the shares held by NVP XII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XII, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Read SEC document
July 29, 2019 Filed Jul 29, 2019 21:02 UTC Health Catalyst, Inc. HCAT · Entity 1565 ConversionSeries D Convertible Preferred Stock · Derivative 471,831 $0.00 $0.00
Disclosure

SEC source: 0001209191-19-043590 · doc4.xml · derivative · entry 10

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Indirect · By Limited Partnership

Disclosed balance after: 0

Underlying: Common Stock · 471,831 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F4 · derivative.exercise_price: The Series D Convertible 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 Common Stock and has no expiration date.

F4 · derivative.exercise_date: The Series D Convertible 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 Common Stock and has no expiration date.

F4 · derivative.expiration_date: The Series D Convertible 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 Common Stock and has no expiration date.

F7 · ownership.nature: The securities shown on Line 2 of Table I and Lines 6 through 10 of Table II represent securities held of record by Norwest Venture Partners XII, LP ("NVP XII"). Genesis VC Partners XII, LLC ("Genesis XII") is the general partner of NVP XII and may be deemed to have sole voting and dispositive power over the shares held by NVP XII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XII, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Read SEC document
July 29, 2019 Filed Jul 29, 2019 21:02 UTC Health Catalyst, Inc. HCAT · Entity 1565 ConversionSeries C Convertible Preferred Stock · Derivative 577,045 $0.00 $0.00
Disclosure

SEC source: 0001209191-19-043590 · doc4.xml · derivative · entry 9

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Indirect · By Limited Partnership

Disclosed balance after: 0

Underlying: Common Stock · 577,045 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F3 · derivative.exercise_price: The Series C Convertible 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 Common Stock and has no expiration date.

F3 · derivative.exercise_date: The Series C Convertible 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 Common Stock and has no expiration date.

F3 · derivative.expiration_date: The Series C Convertible 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 Common Stock and has no expiration date.

F7 · ownership.nature: The securities shown on Line 2 of Table I and Lines 6 through 10 of Table II represent securities held of record by Norwest Venture Partners XII, LP ("NVP XII"). Genesis VC Partners XII, LLC ("Genesis XII") is the general partner of NVP XII and may be deemed to have sole voting and dispositive power over the shares held by NVP XII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XII, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Read SEC document
July 29, 2019 Filed Jul 29, 2019 21:02 UTC Health Catalyst, Inc. HCAT · Entity 1565 ConversionSeries B Convertible Preferred Stock · Derivative 1,442,727 $0.00 $0.00
Disclosure

SEC source: 0001209191-19-043590 · doc4.xml · derivative · entry 8

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Indirect · By Limited Partnership

Disclosed balance after: 0

Underlying: Common Stock · 1,442,727 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F2 · derivative.exercise_price: The Series B Convertible 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 Common Stock and has no expiration date.

F2 · derivative.exercise_date: The Series B Convertible 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 Common Stock and has no expiration date.

F2 · derivative.expiration_date: The Series B Convertible 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 Common Stock and has no expiration date.

F7 · ownership.nature: The securities shown on Line 2 of Table I and Lines 6 through 10 of Table II represent securities held of record by Norwest Venture Partners XII, LP ("NVP XII"). Genesis VC Partners XII, LLC ("Genesis XII") is the general partner of NVP XII and may be deemed to have sole voting and dispositive power over the shares held by NVP XII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XII, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Read SEC document
July 29, 2019 Filed Jul 29, 2019 21:02 UTC Health Catalyst, Inc. HCAT · Entity 1565 ConversionSeries F Convertible Preferred Stock · Derivative 35,919 $0.00 $0.00
Disclosure

SEC source: 0001209191-19-043590 · doc4.xml · derivative · entry 7

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 0

Underlying: Common Stock · 35,919 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · security: The securities shown on Line 1 of Table I and Lines 1 through 5 of Table II represent securities held of record by Norwest Venture Partners XI, LP ("NVP XI"). Genesis VC Partners XI, LLC ("Genesis XI") is the general partner of NVP XI and may be deemed to have sole voting and dispositive power over the shares held by NVP XI. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XI, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F6 · derivative.exercise_price: The Series F Convertible 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 Common Stock and has no expiration date.

F6 · derivative.exercise_date: The Series F Convertible 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 Common Stock and has no expiration date.

F6 · derivative.expiration_date: The Series F Convertible 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 Common Stock and has no expiration date.

Read SEC document
July 29, 2019 Filed Jul 29, 2019 21:02 UTC Health Catalyst, Inc. HCAT · Entity 1565 ConversionSeries E Convertible Preferred Stock · Derivative 424,568 $0.00 $0.00
Disclosure

SEC source: 0001209191-19-043590 · doc4.xml · derivative · entry 6

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 0

Underlying: Common Stock · 424,568 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · security: The securities shown on Line 1 of Table I and Lines 1 through 5 of Table II represent securities held of record by Norwest Venture Partners XI, LP ("NVP XI"). Genesis VC Partners XI, LLC ("Genesis XI") is the general partner of NVP XI and may be deemed to have sole voting and dispositive power over the shares held by NVP XI. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XI, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F5 · derivative.exercise_price: The Series E Convertible 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 Common Stock and has no expiration date.

F5 · derivative.exercise_date: The Series E Convertible 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 Common Stock and has no expiration date.

F5 · derivative.expiration_date: The Series E Convertible 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 Common Stock and has no expiration date.

Read SEC document
July 29, 2019 Filed Jul 29, 2019 21:02 UTC Health Catalyst, Inc. HCAT · Entity 1565 ConversionSeries D Convertible Preferred Stock · Derivative 471,832 $0.00 $0.00
Disclosure

SEC source: 0001209191-19-043590 · doc4.xml · derivative · entry 5

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 0

Underlying: Common Stock · 471,832 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · security: The securities shown on Line 1 of Table I and Lines 1 through 5 of Table II represent securities held of record by Norwest Venture Partners XI, LP ("NVP XI"). Genesis VC Partners XI, LLC ("Genesis XI") is the general partner of NVP XI and may be deemed to have sole voting and dispositive power over the shares held by NVP XI. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XI, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F4 · derivative.exercise_price: The Series D Convertible 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 Common Stock and has no expiration date.

F4 · derivative.exercise_date: The Series D Convertible 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 Common Stock and has no expiration date.

F4 · derivative.expiration_date: The Series D Convertible 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 Common Stock and has no expiration date.

Read SEC document
July 29, 2019 Filed Jul 29, 2019 21:02 UTC Health Catalyst, Inc. HCAT · Entity 1565 ConversionSeries C Convertible Preferred Stock · Derivative 577,045 $0.00 $0.00
Disclosure

SEC source: 0001209191-19-043590 · doc4.xml · derivative · entry 4

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 0

Underlying: Common Stock · 577,045 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · security: The securities shown on Line 1 of Table I and Lines 1 through 5 of Table II represent securities held of record by Norwest Venture Partners XI, LP ("NVP XI"). Genesis VC Partners XI, LLC ("Genesis XI") is the general partner of NVP XI and may be deemed to have sole voting and dispositive power over the shares held by NVP XI. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XI, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F3 · derivative.exercise_price: The Series C Convertible 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 Common Stock and has no expiration date.

F3 · derivative.exercise_date: The Series C Convertible 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 Common Stock and has no expiration date.

F3 · derivative.expiration_date: The Series C Convertible 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 Common Stock and has no expiration date.

Read SEC document
July 29, 2019 Filed Jul 29, 2019 21:02 UTC Health Catalyst, Inc. HCAT · Entity 1565 ConversionSeries B Convertible Preferred Stock · Derivative 1,442,727 $0.00 $0.00
Disclosure

SEC source: 0001209191-19-043590 · doc4.xml · derivative · entry 3

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 0

Underlying: Common Stock · 1,442,727 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · security: The securities shown on Line 1 of Table I and Lines 1 through 5 of Table II represent securities held of record by Norwest Venture Partners XI, LP ("NVP XI"). Genesis VC Partners XI, LLC ("Genesis XI") is the general partner of NVP XI and may be deemed to have sole voting and dispositive power over the shares held by NVP XI. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XI, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F2 · derivative.exercise_price: The Series B Convertible 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 Common Stock and has no expiration date.

F2 · derivative.exercise_date: The Series B Convertible 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 Common Stock and has no expiration date.

F2 · derivative.expiration_date: The Series B Convertible 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 Common Stock and has no expiration date.

Read SEC document
July 29, 2019 Filed Jul 29, 2019 21:02 UTC Health Catalyst, Inc. HCAT · Entity 1565 ConversionCommon Stock 2,952,090 Not disclosed Not disclosed
Disclosure

SEC source: 0001209191-19-043590 · doc4.xml · nonDerivative · entry 2

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Indirect · By Limited Partnership

Disclosed balance after: 2,952,090

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F2 · price: The Series B Convertible 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 Common Stock and has no expiration date.

F3 · price: The Series C Convertible 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 Common Stock and has no expiration date.

F4 · price: The Series D Convertible 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 Common Stock and has no expiration date.

F5 · price: The Series E Convertible 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 Common Stock and has no expiration date.

F6 · price: The Series F Convertible 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 Common Stock and has no expiration date.

F7 · ownership.nature: The securities shown on Line 2 of Table I and Lines 6 through 10 of Table II represent securities held of record by Norwest Venture Partners XII, LP ("NVP XII"). Genesis VC Partners XII, LLC ("Genesis XII") is the general partner of NVP XII and may be deemed to have sole voting and dispositive power over the shares held by NVP XII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XII, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

Read SEC document
July 29, 2019 Filed Jul 29, 2019 21:02 UTC Health Catalyst, Inc. HCAT · Entity 1565 ConversionCommon Stock 2,952,091 Not disclosed Not disclosed
Disclosure

SEC source: 0001209191-19-043590 · doc4.xml · nonDerivative · entry 1

Norwest Venture Partners XI, LP · CIK 0001534522 · 10% owner

Norwest Venture Partners XII, LP · CIK 0001614660 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 2,952,091

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · security: The securities shown on Line 1 of Table I and Lines 1 through 5 of Table II represent securities held of record by Norwest Venture Partners XI, LP ("NVP XI"). Genesis VC Partners XI, LLC ("Genesis XI") is the general partner of NVP XI and may be deemed to have sole voting and dispositive power over the shares held by NVP XI. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XI, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F2 · price: The Series B Convertible 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 Common Stock and has no expiration date.

F3 · price: The Series C Convertible 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 Common Stock and has no expiration date.

F4 · price: The Series D Convertible 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 Common Stock and has no expiration date.

F5 · price: The Series E Convertible 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 Common Stock and has no expiration date.

F6 · price: The Series F Convertible 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 Common Stock and has no expiration date.

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April 08, 2019 Filed Apr 10, 2019 18:31 UTC Silk Road Medical Inc SILK · Entity 87417 OtherWarrant (Right to buy) · Derivative 3,764 $0.00 Strike: $8.27 $0.00
Disclosure

SEC source: 0001209191-19-024306 · doc4.xml · derivative · entry 4

Norwest Venture Partners XIII, LP · CIK 0001772583 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 0

Underlying: Common Stock · 3,764 shares

Expires 2024-12-21

F1 · security: The securities shown on Lines 1 and 2 of Table I and Lines 1 and 2 of Table II represent securities held of record by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and may be deemed to have sole voting and dispositive power over the shares held by NVP XIII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIII, and Promod Haque, Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Haque, Crowe, and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F3 · derivative.exercise_date: All of the shares subject to the warrant are fully exercisable as of the date hereof.

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April 08, 2019 Filed Apr 10, 2019 18:31 UTC Silk Road Medical Inc SILK · Entity 87417 ConversionSeries C Preferred Stock · Derivative 2,458,210 $0.00 $0.00
Disclosure

SEC source: 0001209191-19-024306 · doc4.xml · derivative · entry 3

Norwest Venture Partners XIII, LP · CIK 0001772583 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 0

Underlying: Common Stock · 2,458,210 shares

Expires not disclosed

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · security: The securities shown on Lines 1 and 2 of Table I and Lines 1 and 2 of Table II represent securities held of record by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and may be deemed to have sole voting and dispositive power over the shares held by NVP XIII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIII, and Promod Haque, Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Haque, Crowe, and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F2 · derivative.exercise_price: The Series C 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 Common Stock and has no expiration date.

F2 · derivative.exercise_date: The Series C 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 Common Stock and has no expiration date.

F2 · derivative.expiration_date: The Series C 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 Common Stock and has no expiration date.

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April 08, 2019 Filed Apr 10, 2019 18:31 UTC Silk Road Medical Inc SILK · Entity 87417 OtherCommon Stock 3,764 $8.27 $31,128.28
Disclosure

SEC source: 0001209191-19-024306 · doc4.xml · nonDerivative · entry 2

Norwest Venture Partners XIII, LP · CIK 0001772583 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 2,461,974

F1 · security: The securities shown on Lines 1 and 2 of Table I and Lines 1 and 2 of Table II represent securities held of record by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and may be deemed to have sole voting and dispositive power over the shares held by NVP XIII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIII, and Promod Haque, Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Haque, Crowe, and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

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April 08, 2019 Filed Apr 10, 2019 18:31 UTC Silk Road Medical Inc SILK · Entity 87417 ConversionCommon Stock 2,458,210 Not disclosed Not disclosed
Disclosure

SEC source: 0001209191-19-024306 · doc4.xml · nonDerivative · entry 1

Norwest Venture Partners XIII, LP · CIK 0001772583 · 10% owner

Crowe Jeffrey · CIK 0001535261 · 10% owner

Kossow Jon Erik · CIK 0001726084 · 10% owner

HAQUE PROMOD · CIK 0001089744 · 10% owner

Joint disclosure: these amounts are not allocated separately to each reporting owner.

10b5-1 filing: Not disclosed

Ownership: Direct

Disclosed balance after: 2,458,210

Exercise/conversion can include RSU settlement. Transaction price and option strike are different fields; a missing price is not zero. Derivative and underlying rows can describe the same event.

F1 · security: The securities shown on Lines 1 and 2 of Table I and Lines 1 and 2 of Table II represent securities held of record by Norwest Venture Partners XIII, LP ("NVP XIII"). Genesis VC Partners XIII, LLC ("Genesis XIII") is the general partner of NVP XIII and may be deemed to have sole voting and dispositive power over the shares held by NVP XIII. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIII, and Promod Haque, Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Haque, Crowe, and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.

F2 · price: The Series C 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 Common Stock and has no expiration date.

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Value uses the disclosed total when available, otherwise shares × reported transaction price. It is not an estimate of exercise cash cost or investment performance.