SEC Form 4
FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol Blue Apron Holdings, Inc. [ APRN ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Date of Earliest Transaction (Month/Day/Year) 09/15/2021 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Class A Common Stock | 09/15/2021 | A | 300,000 | A | (1) | 441,132 | D | |||
Class A Common Stock | 09/15/2021 | C | 1,115,161(2) | A | $0 | 1,556,293 | D | |||
Class A Common Stock | 09/15/2021 | C | 1,316,272(2) | A | $0 | 1,316,272 | I | See Footnote(3) | ||
Class A Common Stock | 09/15/2021 | C | 180,906(2) | A | $0 | 180,906 | I | By MS 2018 Trust I(4) | ||
Class A Common Stock | 09/15/2021 | C | 180,906(2) | A | $0 | 180,906 | I | By MS 2018 Trust II(5) | ||
Class A Common Stock | 09/15/2021 | C | 166,666(2) | A | $0 | 166,666 | I | By The Matthew Salzberg Family 2014 Trust(6) | ||
Class A Common Stock | 09/15/2021 | C | 1,250(2) | A | $0 | 1,250 | I | See Footnote(7) | ||
Class A Common Stock | 09/15/2021 | M | 12,494 | A | (8) | 1,568,787 | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Warrants (right to buy Class A Common Stock) | $15 | 09/15/2021 | A | 240,000 | 09/15/2021 | 09/15/2028 | Class A Common Stock | 240,000 | (1) | 240,000 | D | ||||
Warrants (right to buy Class A Common Stock) | $18 | 09/15/2021 | A | 120,000 | 09/15/2021 | 09/15/2028 | Class A Common Stock | 120,000 | (1) | 120,000 | D | ||||
Warrants (right to buy Class A Common Stock) | $20 | 09/15/2021 | A | 60,000 | 09/15/2021 | 09/15/2028 | Class A Common Stock | 60,000 | (1) | 60,000 | D | ||||
Class B Common Stock | (9) | 09/15/2021 | C | 1,115,161 | (9) | (9) | Class A Common Stock | 1,115,161 | $0 | 0 | D | ||||
Class B Common Stock | (9) | 09/15/2021 | C | 1,316,272 | (9) | (9) | Class A Common Stock | 1,316,272 | $0 | 0 | I | See Footnote(3) | |||
Class B Common Stock | (9) | 09/15/2021 | C | 180,906 | (9) | (9) | Class A Common Stock | 180,906 | $0 | 0 | I | By MS 2018 Trust I(4) | |||
Class B Common Stock | (9) | 09/15/2021 | C | 180,906 | (9) | (9) | Class A Common Stock | 180,906 | $0 | 0 | I | By MS 2018 Trust II(5) | |||
Class B Common Stock | (9) | 09/15/2021 | C | 166,666 | (9) | (9) | Class A Common Stock | 166,666 | $0 | 0 | I | By The Matthew Salzberg Family 2014 Trust(6) | |||
Class B Common Stock | (9) | 09/15/2021 | C | 1,250 | (9) | (9) | Class A Common Stock | 1,250 | $0 | 0 | I | See Footnote(7) | |||
Stock Option (right to buy Class B Common Stock) | $116.25(9) | 09/15/2021 | C | 3,110 | (10) | 03/12/2022 | Class B Common Stock | 3,110 | $0 | 0 | D | ||||
Stock Option (right to buy Class A Common Stock) | $116.25(9) | 09/15/2021 | C | 3,110 | (10) | 03/12/2022 | Class A Common Stock | 3,110 | $0 | 3,110 | D | ||||
Restricted Stock Units | (8) | 09/15/2021 | M | 12,494 | (11) | (11) | Class A Common Stock | 12,494 | $0 | 0 | D |
Explanation of Responses: |
1. The reported securities were acquired by the reporting person for an effective price of $10.00 per unit, with each unit consisting of one share of Class A Common Stock, one warrant to acquire 0.8 shares of Class A Common Stock with an exercise price of $15 per share, one warrant to acquire 0.4 shares of Class A Common Stock with an exercise price of $18 per share, and one warrant to acquire 0.2 shares of Class A Common Stock with an exercise price of $20.00 per share. |
2. Represents the number of shares that were acquired upon conversion of the shares of the issuer's Class B Common Stock listed in Table II, as described in footnote 9 below. |
3. Represents shares held of record by Family Trust Created Under Article V of the Matthew Salzberg 2014 Annuity Trust Agreement (the "2014 Annuity Trust"), for which the reporting person and his father, Barry Salzberg, serve as co-trustees. The reporting person disclaims beneficial ownership of the shares owned by the 2014 Annuity Trust except to the extent of any pecuniary interest therein. |
4. Represents shares held of record by MS 2018 Trust I, for which the reporting person and his father, Barry Salzberg, serve as co-trustees. The reporting person disclaims beneficial ownership of the shares owned by MS 2018 Trust I except to the extent of any pecuniary interest therein. |
5. Represents shares held of record by MS 2018 Trust II, for which the reporting person and his father, Barry Salzberg, serve as co-trustees. The reporting person disclaims beneficial ownership of the shares owned by MS 2018 Trust II except to the extent of any pecuniary interest therein. |
6. Represents shares held of record by The Matthew Salzberg Family 2014 Trust (the "2014 Family Trust"), for which the reporting person serves as trustee. The reporting person disclaims beneficial ownership of shares owned by the 2014 Family Trust except to the extent of any pecuniary interest therein. |
7. Represents the shares held of record by Aspiration Growth Opportunities II GP, LLC, with respect to which the reporting person has shared investment and voting power. The reporting person disclaims beneficial ownership of shares owned by Aspiration Growth Opportunities II GP, LLC except to the extent of any pecuniary interest therein. |
8. Restricted stock units ("RSUs") convert into Class A Common Stock on a one-for-one basis. |
9. The issuer's Class B Common Stock was converted in full to Class A Common Stock on a one-for-one basis on the date reported upon the election of the reporting person and certain other holders of the Class B Common Stock, resulting in a mandatory conversion of all shares of Class B Common Stock on such date under the terms of the issuer's certificate of incorporation. Prior to such conversion the Class B shares were exercisable at the holder's election and had no expiration date. |
10. This option was granted to the reporting person on March 13, 2017 and vested in equal monthly installments over four years from February 19, 2017. In connection with the events described in footnote 9 above, such option became exercisable for shares of Class A Common Stock. |
11. On June 14, 2021, the reporting person was granted 12,494 RSUs, which were scheduled to vest in full on the earlier of June 14, 2022 and the date of the issuer's 2022 Annual Meeting of Stockholders. This transaction represents the accelerated settlement of such RSUs in shares of Class A Common Stock. |
/s/ Matthew B. Salzberg | 09/17/2021 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |