SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 05/10/2021 | 3. Issuer Name and Ticker or Trading Symbol Squarespace, Inc. [ SQSP ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Class A Common Stock | 933,100 | I | See footnote(1) |
Class A Common Stock | 13,727,746 | I | See footnote(2) |
Class A Common Stock | 268,729 | I | See footnote(3) |
Class A Common Stock | 530,953 | I | See footnote(4) |
Class A Common Stock | 21,982 | I | See footnote(5) |
Class A Common Stock | 31,686 | I | See footnote(6) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
1. The shares are held of record by Accel Growth Fund Investors 2010 L.L.C. Andrew Braccia, Kevin Efrusy, Sameer Gandhi, Ping Li, Tracy Sedlock and Richard Wong are the managing members of Accel Growth Fund Investors 2010 L.L.C. Andrew Braccia disclaims ownership of all such shares except to the extent that he has a pecuniary interest therein. |
2. The shares are held of record by Accel Growth Fund L.P. Accel Growth Fund Associates L.L.C. ("AGFA") is the general partner of Accel Growth Fund L.P. Andrew Braccia, Kevin Efrusy, Sameer Gandhi, Ping Li, Tracy Sedlock and Richard Wong are the managing members of AGFA. Andrew Braccia disclaims ownership of all such shares except to the extent that he has a pecuniary interest therein. |
3. The shares are held of record by Accel Growth Fund Strategic Partners L.P. AGFA is the general partner of Accel Growth Fund Strategic Partners L.P. Andrew Braccia, Kevin Efrusy, Sameer Gandhi, Ping Li, Tracy Sedlock and Richard Wong are the managing members of AGFA. Andrew Braccia disclaims ownership of all such shares except to the extent that he has a pecuniary interest therein. |
4. The shares are held of record by Accel Leaders 3 L.P. Accel Leaders 3 GP Associates L.L.C. ("AL3A") is the general partner of the general partner of Accel Leaders 3 L.P. Andrew Braccia, Sameer Gandhi, Ping Li, Tracy Sedlock, Ryan Sweeney and Richard Wong are the directors of AL3A. Andrew Braccia disclaims ownership of all such shares except to the extent that he has a pecuniary interest therein. |
5. The shares are held of record by Accel Leaders 3 Entrepreneurs L.P. AL3A is the general partner of the general partner of Accel Leaders 3 Entrepreneurs L.P. Andrew Braccia, Sameer Gandhi, Ping Li, Tracy Sedlock, Ryan Sweeney and Richard Wong are the directors of AL3A. Andrew Braccia disclaims ownership of all such shares except to the extent that he has a pecuniary interest therein. |
6. The shares are held of record by Accel Leaders 3 Investors (2020) L.P. AL3A is the general partner of Accel Leaders 3 Investors (2020) L.P. Andrew Braccia, Sameer Gandhi, Ping Li, Tracy Sedlock, Ryan Sweeney and Richard Wong are the directors of AL3A. Andrew Braccia disclaims ownership of all such shares except to the extent that he has a pecuniary interest therein. |
Remarks: |
Exhibit 24 - Power of Attorney |
/s/ Jessica Krasner, as Attorney-in-Fact | 05/10/2021 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |