Statement of Changes in Beneficial Ownership (4)
December 12 2019 - 5:46PM
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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3235-0287
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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
*
Harnett Samantha |
2. Issuer Name and Ticker or Trading Symbol
Eventbrite, Inc.
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EB
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
__X__ Officer (give title below) __X__ Other (specify below)
Chief Legal & Corp Ops Officer
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Chief Legal & Corp Ops Officer |
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(Last)
(First)
(Middle)
C/O EVENTBRITE, INC., 155 5TH STREET, FLOOR 7 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/10/2019 |
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(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
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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| Class A Common Stock | 12/10/2019 | | C | | 579 | A | $0.0 | 12627 | D | |
| Class A Common Stock | 12/10/2019 | | C | | 1151 | A | $0.0 | 13778 | D | |
| Class A Common Stock | 12/10/2019 | | S(1) | | 2675 | D | $19.52 | 11103 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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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 | (2) | 12/10/2019 | | M | | 579 | | (2) | (2) | Class A Common Stock | 579 | $0.0 | 579 | D | |
| Class B Common Stock | (2) | 12/10/2019 | | C | | | 579 | (2) | (2) | Class A Common Stock | 579 | $0.0 | 0 | D | |
| Class B Common Stock | (2) | 12/10/2019 | | M | | 1151 | | (2) | (2) | Class A Common Stock | 1151 | $0.0 | 1151 | D | |
| Class B Common Stock | (2) | 12/10/2019 | | C | | | 1151 | (2) | (2) | Class A Common Stock | 1151 | $0.0 | 0 | D | |
| Stock Option (Right to Buy) | $6.79 | 12/10/2019 | | M | | | 579 | (3) | 5/22/2027 | Class B Common Stock | 579 | $0.0 | 27379 | D | |
| Stock Option (Right to Buy) | $7.24 | 12/10/2019 | | M | | | 1151 | (4) | 11/9/2025 | Class B Common Stock | 1151 | $0.0 | 31584 | D | |
| Explanation of Responses: |
| (1) | This transaction was effected pursuant to a Rule 10b5-1 trading plan previously adopted by the Reporting Person. |
| (2) | Each share of Class B common stock is convertible into one share of Class A common stock at the option of the holder and has no expiration date. |
| (3) | The stock option will vest and become exercisable in 48 equal monthly installments from May 1, 2017 to May 1, 2021, subject to the Reporting Person's continued service to the Issuer. |
| (4) | The stock option vested and became exercisable with respect to 25% of the shares on November 10, 2016 and will vest and become exercisable thereafter in 36 additional monthly installments through through November 10, 2019, subject to the Reporting Person's continued service to the Issuer. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Harnett Samantha
C/O EVENTBRITE, INC.
155 5TH STREET, FLOOR 7
SAN FRANCISCO, CA 94103 |
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| Chief Legal & Corp Ops Officer | Chief Legal & Corp Ops Officer |
Signatures
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| Samantha Harnett | | 12/12/2019 |
| **Signature of Reporting Person | Date |
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