1. Name and Address of Reporting Person*MAYFIELD XV, A CAYMAN ISLANDS EXEMPTED LIMITED PARTNERSHIP | (Street) | 2. Date of Event Requiring Statement (Month/Day/Year) 06/16/2022 | 3. Issuer Name and Ticker or Trading Symbol Grove Collaborative Holdings, Inc. [ GROV ] |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable) | Director | X | 10% Owner | | Officer (give title below) | | Other (specify below) | | | 5. If Amendment, Date of Original Filed (Month/Day/Year) 06/21/2022 |
6. Individual or Joint/Group Filing (Check Applicable Line) | Form filed by One Reporting Person | X | Form filed by More than One Reporting Person | |
1. Name and Address of Reporting Person*MAYFIELD XV, A CAYMAN ISLANDS EXEMPTED LIMITED PARTNERSHIP | (Street) |
1. Name and Address of Reporting Person*Mayfield XV Management (EGP), L.P. | (Street) |
1. Name and Address of Reporting Person*Mayfield XV Management (UGP), Ltd. | (Street) |
1. Name and Address of Reporting Person*MAYFIELD SELECT, A CAYMAN ISLANDS EXEMPTED LIMITED PARTNERSHIP | (Street) |
1. Name and Address of Reporting Person*Mayfield Select Management (EGP), L.P. | (Street) |
1. Name and Address of Reporting Person*Mayfield Select Management (UGP), Ltd. | (Street) |
| Mayfield XV, a Cayman Islands Exempted Limited Partnership, By: Mayfield XV Management (EGP), L.P., its general partner, By: Mayfield XV Management (UGP), Ltd., its general partner, By: /s/ Paul Kohli, Authorized Signatory | 06/27/2022 |
| Mayfield XV Management (EGP), L.P., a Cayman Islands Exempted Limited Partnership, By: Mayfield XV Management (UGP), Ltd., its general partner, By: /s/ Paul Kohli, Authorized Signatory | 06/27/2022 |
| Mayfield XV Management (UGP), Ltd., a Cayman Islands Exempted Company, By: /s/ Paul Kohli, Authorized Signatory | 06/27/2022 |
| Mayfield Select, a Cayman Islands Exempted Limited Partnership, By: Mayfield Select Management (EGP), L.P., its general partner, By: Mayfield Select Management (UGP), Ltd., its general partner, By: /s/ Paul Kohli, Authorized Signatory | 06/27/2022 |
| Mayfield Select Management (EGP), L.P., a Cayman Islands Exempted Limited Partnership, By: Mayfield Select Management (UGP), Ltd., its general partner, By: /s/ Paul Kohli, Authorized Signatory | 06/27/2022 |
| Mayfield Select Management (UGP), Ltd., a Cayman Islands Exempted Company, /s/ Paul Kohli, Authorized Signatory | 06/27/2022 |
| ** 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. |