SEC Form 4 · accession 0001209191-15-049046
Carbonite Inc · CARB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Pravin A Vazirani
Director · 10% Owner
Period of report
Jun 1, 2015
Accepted (ET)
Jun 2, 2015 · 5:06 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001340127
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jun 1, 2015 | A | 4,500 | $0.00 | A | 10,004 | D | |
| Common StockF2 | holding | — | — | — | 3,238,961 | I | By Menlo Ventures X, L.P. | |
| Common StockF3 | holding | — | — | — | 27,531 | I | By Menlo Entrepreneurs Fund X, L.P | |
| Common StockF4 | holding | — | — | — | 56,686 | I | By MMEF X, L.P. |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F5 | $11.14 | Jun 1, 2015 | A | 9,000 | A | — | Jun 1, 2025 | Common Stock | 9,000 | 9,000 | D |
Explanation of responses
- F1Reflects the grant of restricted stock that will vest in full and no longer be subject to forfeiture on June 1, 2016, subject to the Registrant's continuing service as a director. This restricted stock grant also provides for accelerated vesting on an acquisition of the Issuer.
- F2These shares are owned directly by Menlo Ventures X, L.P. ("Menlo X"), whose sole general partner is MV Management X, L.L.C. ("MVM-X") of which Pravin A. Vazirani is a managing member and shares voting and investment power over the shares held by Menlo X. The reporting person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for Section 16 or any other purpose.
- F3These shares are owned directly by Menlo Entrepreneurs Fund X, L.P., whose sole general partner is MVM-X of which Pravin A. Vazirani is a managing member and shares voting and investment power over the shares held by Menlo Entrepreneurs Fund X, L.P. The reporting person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for Section 16 or any other purpose.
- F4These shares are owned directly by MMEF X, L.P., whose sole general partner is MVM-X of which Pravin A. Vazirani is a managing member and shares voting and investment power over the shares held by MMEF X, L.P. The reporting person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for Section 16 or any other purpose.
- F5This option becomes exercisable in one installment on June 1, 2016, subject to the Registrant's continuing service as a director. This stock option grant also provides for accelerated vesting on an acquisition of the Issuer.