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) 07/15/2021 | 3. Issuer Name and Ticker or Trading Symbol Blend Labs, Inc. [ BLND ] | |||||||||||||
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(1) | 1,083,333 | I | By Lightspeed Venture Partners IX, L.P(2) |
Class A Common Stock(1) | 1,492,537 | I | By Lightspeed Venture Partners Select, L.P.(3) |
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 | ||||
Class B Common Stock(1) | (1) | (1) | Class A Common Stock(1) | 463,061 | (1) | I | By Lightspeed Venture Partners IX, L.P(2) |
Series A Preferred Stock | (4) | (4) | Class B Common Stock(1) | 7,606,645 | (4) | I | By Lightspeed Venture Partners IX, L.P(2) |
Series B Preferred Stock | (4) | (4) | Class B Common Stock(1) | 3,856,742 | (4) | I | By Lightspeed Venture Partners IX, L.P(2) |
Series B-1 Preferred Stock | (4) | (4) | Class B Common Stock(1) | 2,724,414 | (4) | I | By Lightspeed Venture Partners IX, L.P(2) |
Series D Preferred Stock | (4) | (4) | Class B Common Stock(1) | 1,684,160 | (4) | I | By Lightspeed Venture Partners IX, L.P(2) |
Series C Preferred Stock | (4) | (4) | Class B Common Stock(1) | 2,870,685 | (4) | I | By Lightspeed Venture Partners Select, L.P.(3) |
Series D Preferred Stock | (4) | (4) | Class B Common Stock(1) | 1,684,160 | (4) | I | By Lightspeed Venture Partners Select, L.P.(3) |
Series E Preferred Stock | (4) | (4) | Class B Common Stock(1) | 2,261,500 | (4) | I | By Lightspeed Venture Partners Select III, L.P.(5) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. Immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock, each share of Class A Common Stock as currently named will be reclassified into one share of Class B Common Stock and each share of Class B Common Stock as currently named will be reclassified into one share of Class A Common Stock. This Form 3 assumes all shares have been renamed as if such reclassification has already occurred. |
2. Shares are held by Lightspeed Venture Partners IX, L.P ("Lightspeed IX"). Lightspeed General Partner IX, L.P. ("LGP IX"), is the general partner of Lightspeed IX. Lightspeed Ultimate General Partner IX, Ltd. ("LUGP IX") is the general partner of LGP IX. Barry Eggers, Ravi Mhatre, and Peter Nieh are the directors of LUGP IX and share voting and dispositive power with respect to the shares held by Lightspeed IX. Messrs. Eggers, Mhatre, and Nieh disclaim beneficial ownership of the shares held by Lightspeed IX except to the extent of their respective pecuniary interests therein. |
3. Shares are held by Lightspeed Venture Partners Select, L.P. ("Lightspeed Select"). Lightspeed General Partner Select, L.P. ("LGP Select") is the general partner of Lightspeed Select. Lightspeed Ultimate General Partner Select, Ltd. ("LUGP Select") is the general partner of LGP Select. Barry Eggers, Jeremy Liew, Ravi Mhatre and Peter Nieh are the directors of LUGP Select and share voting and dispositive power with respect to the shares held by Lightspeed Select. LGP Select, LUGP Select and Messrs. Eggers, Liew, Mhatre and Nieh disclaim beneficial ownership of the shares held by Lightspeed Select, except to the extent of their respective pecuniary interests therein. |
4. Each share of Series A Preferred Stock, Series B Preferred Stock. Series B-1 Preferred Stock, Series C Preferred Stock, Series D Preferred Stock and Series E Preferred Stock will convert into Class A Common Stock immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock and has no expiration date. |
5. Shares are held by Lightspeed Venture Partners Select III, L.P. ("Lightspeed Select III"). Lightspeed Ultimate General Partner Select III, Ltd ("LUGP Select III") is the general partner of Lightspeed Select III. Barry Eggers, Jeremy Liew, Ravi Mhatre, and Peter Nieh are the directors of LUGP Select III and share voting and dispositive power with respect to the shares held by Lightspeed Select III. LUGP Select III and Messrs. Eggers, Liew, Mhatre and Nieh disclaim beneficial ownership of the shares held by Lightspeed Select III, except to the extent of their respective pecuniary interests therein. |
Remarks: |
/s/ Ravi Mhatre | 07/15/2021 | |
/s/ Barry Eggers | 07/15/2021 | |
/s/ Peter Nieh | 07/15/2021 | |
** 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. |