Statement of Changes in Beneficial Ownership (4)
December 16 2020 - 06:28PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
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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 * JORDAN JEFFREY D |
2. Issuer Name and Ticker or Trading
Symbol Airbnb, Inc. [ ABNB ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
_____ Officer (give title
below) _____ Other
(specify below)
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(Last)
(First)
(Middle)
888 BRANNAN STREET |
3. Date of Earliest Transaction (MM/DD/YYYY)
12/14/2020
|
(Street)
SAN FRANCISCO, CA 94103
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line) _X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. Code
(Instr. 8) |
5. Number of Derivative Securities Acquired (A) or
Disposed of (D)
(Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date |
7. Title and Amount of Securities Underlying
Derivative Security
(Instr. 3 and 4) |
8. Price of Derivative Security
(Instr. 5) |
9. Number of derivative Securities Beneficially
Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct
(D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Class B Common Stock |
(1) |
12/14/2020 |
|
C |
|
9688206 |
|
(1) |
(1) |
Class A Common Stock |
9688206 |
$0.00 |
9688206 |
I |
By AH Annex Fund, L.P. (2)(3) |
Class B Common Stock |
(1) |
12/14/2020 |
|
C |
|
9779518 |
|
(1) |
(1) |
Class A Common Stock |
9779518 |
$0.00 |
9779518 |
I |
By Andreessen Horowitz Fund II,
L.P. (2)(4) |
Class B Common Stock |
(1) |
12/14/2020 |
|
C |
|
235848 |
|
(1) |
(1) |
Class A Common Stock |
235848 |
$0.00 |
235848 |
I |
By AH Parallel Fund, L.P. (2)(5) |
Series B Preferred Stock |
(6) |
12/14/2020 |
|
C |
|
|
9056832 |
(6) |
(6) |
Class B Common Stock |
9056832 |
$0.00 |
0 |
I |
By AH Annex Fund, L.P. (2)(3) |
Series B Preferred Stock |
(6) |
12/14/2020 |
|
C |
|
|
9056832 |
(6) |
(6) |
Class B Common Stock |
9056832 |
$0.00 |
0 |
I |
By Andreessen Horowitz Fund II,
L.P. (2)(4) |
Series C Preferred Stock |
(7) |
12/14/2020 |
|
C |
|
|
608304 |
(7) |
(7) |
Class B Common Stock |
631374 |
$0.00 |
0 |
I |
By AH Annex Fund, L.P. (2)(3) |
Series C Preferred Stock |
(7) |
12/14/2020 |
|
C |
|
|
227232 |
(7) |
(7) |
Class B Common Stock |
235848 |
$0.00 |
0 |
I |
By AH Parallel Fund, L.P. (2)(5) |
Series C Preferred Stock |
(7) |
12/14/2020 |
|
C |
|
|
696276 |
(7) |
(7) |
Class B Common Stock |
722686 |
$0.00 |
0 |
I |
By Andreessen Horowitz Fund II,
L.P. (2)(4) |
Explanation of
Responses: |
(1) |
The Class B Common Stock is
convertible at any time at the option of the holder into the
Issuer's Class A Common Stock on a one-to-one basis. The Class B
Common Stock will automatically convert into shares of the Issuer's
Class A Common Stock on a one-to-one basis upon the earlier of (a)
any transfer of the Class B Common Stock by the holder, whether or
not for value, subject to certain exceptions, (b) the date and
time, or the occurrence of an event, specified by vote or written
consent of the holders of at least 80% of the outstanding shares of
Class B common stock at the time of such vote or consent, voting as
a separate series or (c) the 20-year anniversary of the closing of
the Issuer's initial public offering. |
(2) |
Mr. Jordan is a member of
the general partners of the Andreessen Horowitz Entities (as
defined herein), but he disclaims the existence of a "group" and
disclaims beneficial ownership of the shares held by the Andreessen
Horowitz Entities and this report shall not be deemed an admission
that he is the beneficial owner of such shares, except to the
extent of his pecuniary interest, if any, in such shares by virtue
of his interest in the Andreessen Horowitz Entities, and/or the
general partner entities thereof, as applicable. |
(3) |
These shares are held of
record by AH Annex Fund, L.P. ("AH Annex Fund"). AH Equity Partners
II, L.L.C. ("AH EP II") is the general partner of AH Annex Fund and
has sole voting and dispositive power with regard to the shares
held by AH Annex Fund. The managing members of AH EP II are Marc
Andreessen and Benjamin Horowitz. Marc Andreessen and Benjamin
Horowitz share voting and dispositive power with respect to the
shares held by AH Annex Fund. |
(4) |
These shares are held of
record by Andreessen Horowitz Fund II, L.P., for itself and as
nominee for Andreessen Horowitz Fund II-A, L.P., Andreessen
Horowitz Fund II-B, L.P. and Andreessen Horowitz Fund II-Q, L.P.
(the "AH Fund II Entities"). AH EP II is the general partner of the
AH Fund II Entities and has sole voting and dispositive power with
regard to the shares held by the AH Fund II Entities. The managing
members of AH EP II are Marc Andreessen and Benjamin Horowitz. Marc
Andreessen and Benjamin Horowitz share voting and dispositive power
with respect to the shares held by the AH Fund II
Entities. |
(5) |
These shares are held of
record by AH Parallel Fund, L.P. ("AH Parallel Fund" and together
with AH Annex Fund and the AH Fund II Entities, the "Andreessen
Horowitz Entities"). AH EP II is the general partner of AH Parallel
Fund and has sole voting and dispositive power with regard to the
shares held by AH Parallel Fund. The managing members of AH EP II
are Marc Andreessen and Benjamin Horowitz. Marc Andreessen and
Benjamin Horowitz share voting and dispositive power with respect
to the shares held by AH Parallel Fund. |
(6) |
The Series B Preferred Stock
automatically converted into shares of the Issuer's Class B Common
Stock on a one-to-one basis immediately upon closing of the
Issuer's initial public offering and had no expiration
date. |
(7) |
The Series C Preferred Stock
automatically converted into shares of the Issuer's Class B Common
Stock on approximately a 1:1.0379 basis immediately upon closing of
the Issuer's initial public offering and had no expiration
date. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
JORDAN JEFFREY D
888 BRANNAN STREET
SAN FRANCISCO, CA 94103 |
X |
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Signatures
|
/s/ Brian Savage,
Attorney-in-fact |
|
12/16/2020 |
**Signature of Reporting
Person |
Date |