SEC FORM
3
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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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
C/O BENCHMARK |
2965 WOODSIDE ROAD |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 11/16/2017
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3. Issuer Name and Ticker or Trading Symbol
Stitch Fix, Inc.
[ SFIX ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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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)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series B Preferred Stock |
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Class B Common Stock
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17,882,240 |
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I |
See footnote
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Series C Preferred Stock |
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Class B Common Stock
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1,513,330 |
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I |
See footnote
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Series C Preferred Stock |
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Class B Common Stock
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3,026,665 |
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I |
See footnote
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Explanation of Responses: |
Remarks: |
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/s/ Steven M. Spurlock, by power of attorney for J. William Gurley |
11/16/2017 |
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** 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. |
AGREEMENT TO FILE JOINTLY AND STATEMENT APPOINTING DESIGNATED FILER AND
AUTHORIZED SIGNATORY
Each of the undersigned entities and individuals (collectively, the
"Reporting Persons") hereby authorizes and designates Benchmark Capital
Management Co. VII, L.L.C. or such other person or entity as is designated in
writing by Steven M. Spurlock (the "Designated Filer") as the beneficial owner
to prepare and file on behalf of such Reporting Person individually, or jointly
together with the other Reporting Persons, any and all reports, notices,
communications and other documents (including, but not limited to, reports on
Schedule 13D, Schedule 13G, Form 3, Form 4 and Form 5) that such Reporting
Person may be required to file with the United States Securities and Exchange
Commission pursuant to the Securities Act of 1933, as amended (together with the
implementing regulations thereto, the "Act"), the Securities Exchange Act of
1934, as amended (together with the implementing regulations thereto, the
"Exchange Act") or any other state or federal agency (collectively, the
"Reports") with respect to the Reporting Person's ownership of, or transactions
in, securities of any entity whose securities are beneficially owned (directly
or indirectly) by such Reporting Person (collectively, the "Companies").
Each Reporting Person hereby further authorizes and designates Steven M.
Spurlock (the "Authorized Signatory") to execute and file on behalf of such
Reporting Person the Reports and to perform any and all other acts, which in the
opinion of the Designated Filer or Authorized Signatory may be necessary or
incidental to the performance of the foregoing powers herein granted.
The authority of the Designated Filer and the Authorized Signatory under
this Document with respect to each Reporting Person shall continue until such
Reporting Person is no longer required to file any Reports with respect to the
Reporting Person's ownership of, or transactions in, the securities of the
Companies, unless earlier revoked in writing. Each Reporting Person acknowledges
that the Designated Filer and the Authorized Signatory are not assuming any of
the Reporting Person's responsibilities to comply with the Act or the Exchange
Act.
December 11, 2014 BENCHMARK CAPITAL MANAGEMENT CO. VII, L.L.C.,
a Delaware Limited Liability Company
By: /s/ Steven M. Spurlock
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Steven M. Spurlock, Managing Member
December 11, 2014 BENCHMARK CAPITAL PARTNERS VII, L.P.,
a Delaware Limited Partnership
By: Benchmark Capital Management Co. VII, L.L.C.,
a Delaware Limited Liability Company,
Its General Partner
By: /s/ Steven M. Spurlock
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Steven M. Spurlock, Managing Member
December 11, 2014 BENCHMARK FOUNDERS' FUND VII, L.P.,
a Delaware Limited Partnership
By: Benchmark Capital Management Co. VII, L.L.C.,
a Delaware Limited Liability Company,
Its General Partner
By: /s/ Steven M. Spurlock
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Steven M. Spurlock, Managing Member
December 11, 2014 BENCHMARK FOUNDERS' FUND VII-B, L.P.,
a Delaware Limited Partnership
By: Benchmark Capital Management Co. VII, L.L.C.,
a Delaware Limited Liability Company,
Its General Partner
By: /s/ Steven M. Spurlock
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Steven M. Spurlock, Managing Member
December 11, 2014 By: /s/ Bruce W. Dunlevie
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Bruce W. Dunlevie
December 11, 2014 By: /s/ J. William Gurley
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J. William Gurley
December 11, 2014 By: /s/ Kevin R. Harvey
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Kevin R. Harvey
December 11, 2014 By: /s/ Mitchell H. Lasky
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Mitchell H. Lasky
December 11, 2014 By: /s/ Peter H. Fenton
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Peter H. Fenton
December 11, 2014 By: /s/ Matthew R. Cohler
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Matthew R. Cohler