SEC Form 4 · accession 0001104659-18-049959

Carbon Black, Inc. · CBLK

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Jeff Fagnan

Director

Period of report

May 9, 2018

Accepted (ET)

Aug 6, 2018 · 9:33 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001366527

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1	May 9, 2018	A	6,007	$0.00	A	6,007	D
Common Stock^F2	holding	—	—		—	9,365,231	I	By Atlas Venture Fund VI, L.P.
Common Stock^F3	holding	—	—		—	286,392	I	By Atlas Venture Entrepreneurs' Fund VI, L.P.
Common Stock^F4	holding	—	—		—	171,480	I	By Atlas Venture Fund VI GmbH & Co. KG
Common Stock^F5	holding	—	—		—	181,273	I	By Atlas Venture Fund IX, L.P.
Common Stock^F6	holding	—	—		—	21,079	I	By Accom B9F Investors, LLC
Common Stock^F7	holding	—	—		—	174,500	I	By Accomplice CB Investors, LLC

Table II — derivative securities

No Table II lines on this filing.

Explanation of responses

F1The shares were acquired pursuant to a restricted stock unit award under the 2018 Stock Option and Incentive Plan. Each restricted stock unit represents a contingent right to receive one share of Carbon Black, Inc. common stock. The restricted stock units vest on the earlier of (i) the first anniversary of the vesting commencement date, May 9, 2019 or (ii) the next annual meeting of the Carbon Black Inc.'s shareholders, subject to a continuous service relationship through such date.
F2The shares are held directly by Atlas Venture Fund VI, L.P. ("AVF VI"). Atlas Venture Associates VI, L.P. ("AVA VI LP") is the sole general partner of AVF VI. Atlas Venture Associates VI, Inc. ("AVA VI Inc.") is the sole general partner of AVA VI LP. Mr. Fagnan is a director of AVA VI Inc. and is an investor in a limited partner of AVF VI. Mr. Fagnan disclaims Section 16 beneficial ownership of all shares except to the extent of his pecuniary interest, if any, therein. This report shall not be deemed to be an admission that Mr. Fagnan is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
F3The shares are held directly by Atlas Venture Entrepreneurs' Fund VI, L.P. ("AVEF VI"). AVA VI LP is the sole general partner of AVEF VI. Mr. Fagnan disclaims Section 16 beneficial ownership of all shares except to the extent of his pecuniary interest, if any, therein. This report shall not be deemed to be an admission that Mr. Fagnan is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
F4The shares are held directly by Atlas Venture Fund VI GmbH & Co. KG ("AVFG VI"). AVA VI LP is the managing partner of AVFG VI. Mr. Fagnan disclaims Section 16 beneficial ownership of all shares except to the extent of his pecuniary interest, if any, therein. This report shall not be deemed to be an admission that Mr. Fagnan is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
F5The shares are held directly by Atlas Venture Fund IX, L.P. ("AVF IX"). Atlas Venture Associates IX, L.P. ("AVA IX LP") is the general partner of AVF IX. Atlas Venture Associates IX, LLC ("AVA IX LLC") is the general partner of AVA IX LP. Mr. Fagnan is a member of AVA IX LP. Mr. Fagnan disclaims Section 16 beneficial ownership of all shares except to the extent of his pecuniary interest, if any, therein. This report shall not be deemed to be an admission that Mr. Fagnan is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
F6The shares are held directly by Accom B9F Investors, LLC ("AB9F"). Mr. Fagnan is a member of AB9F. Mr. Fagnan disclaims Section 16 beneficial ownership of all shares except to the extent of his pecuniary interest, if any, therein. This report shall not be deemed to be an admission that Mr. Fagnan is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
F7The shares are held directly by Accomplice CB Investors LLC ("ACBI"). Mr. Fagnan is a member of ACBI. Mr. Fagnan disclaims Section 16 beneficial ownership of all shares except to the extent of his pecuniary interest, if any, therein. This report shall not be deemed to be an admission that Mr. Fagnan is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.