SEC Form 4 · accession 0001209191-16-156221

Everpure, Inc. · P

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

Reporting owner

Director

Period of report

Dec 1, 2016

Accepted (ET)

Dec 20, 2016 · 8:41 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001474432

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Class A Common Stock^F1	Dec 1, 2016	C	2,228,754	$0.00	A	2,228,754	I	By Index Ventures Growth II (Jersey), L.P.
Class A Common Stock^F1	Dec 1, 2016	C	32,942	$0.00	A	32,942	I	By Index Ventures Growth II Parallel Entrepreneur Fund (Jersey), L.P.
Class A Common Stock^F1	Dec 1, 2016	C	4,393,646	$0.00	A	4,393,646	I	By Index Ventures VI (Jersey), L.P.
Class A Common Stock^F1	Dec 1, 2016	C	88,686	$0.00	A	88,686	I	By Index Ventures VI Parallel Entrepreneur Fund (Jersey), L.P.
Class A Common Stock^F1	Dec 1, 2016	C	85,367	$0.00	A	85,367	I	Yucca (Jersey) SLP

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Class B Common Stock^F1,F2	—	Dec 1, 2016	C	2,228,754	D	—	—	Class A Common Stock	2,228,754	2,228,754	I
Class B Common Stock^F1,F2	—	Dec 1, 2016	C	32,942	D	—	—	Class A Common Stock	32,942	32,942	I
Class B Common Stock^F1,F2	—	Dec 1, 2016	C	4,393,646	D	—	—	Class A Common Stock	4,393,646	4,393,646	I
Class B Common Stock^F1,F2	—	Dec 1, 2016	C	88,686	D	—	—	Class A Common Stock	88,686	88,686	I
Class B Common Stock^F1,F2	—	Dec 1, 2016	C	85,367	D	—	—	Class A Common Stock	85,367	85,367	I

F1The Reporting Person is a partner within the Index Ventures group. Advisors within the Index Ventures group provide advice to Index Ventures Growth II (Jersey), L.P., Index Ventures Growth II Parallel Entrepreneur Fund (Jersey), L.P., Index Ventures VI (Jersey), L.P., Index Ventures VI Parallel Entrepreneur Fund (Jersey), L.P. and Yucca (Jersey) SLP (the "Index Funds"). The Reporting Person is involved in making recommendations to the Index Funds, but does not hold voting or dispositive power over the shares held by the Index Funds. 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.
F2The Class B Common Stock is convertible into the issuer's Class A Common Stock on a 1 for 1 basis (a) at the holder's option or (b) upon certain transfers of such shares and has no expiration date.