SEC FORM
4
SEC Form 4
FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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: |
3235-0287 |
Estimated average burden |
hours per response: |
0.5 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
1. Name and Address of Reporting Person*
C/O GENERAL CATALYST PARTNERS |
20 UNIVERSITY ROAD, 4TH FLOOR |
(Street)
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2. Issuer Name and Ticker or Trading Symbol
HUBSPOT INC
[ HUBS ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
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10% Owner |
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Officer (give title below) |
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Other (specify below) |
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3. Date of Earliest Transaction
(Month/Day/Year) 06/02/2015
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4. 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 Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction 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 |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
06/02/2015 |
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J
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1,008,743 |
D |
$0
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4,707,470 |
I |
See footnote
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Common Stock |
06/02/2015 |
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J
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21,056 |
D |
$0
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98,261 |
I |
See footnote
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Common Stock |
06/02/2015 |
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J
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195,355 |
A |
$0
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195,355 |
I |
See footnote
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Common Stock |
06/02/2015 |
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J
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195,355 |
D |
$0
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0 |
I |
See footnote
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Common Stock |
06/02/2015 |
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J
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8,153 |
A |
$0
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8,153 |
D |
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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11. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Explanation of Responses: |
Remarks: |
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/s/ Christopher McCain, attorney-in-fact for Lawrence S. Bohn |
06/02/2015 |
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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
4
(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. |
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, that each of the undersigned
hereby constitutes and appoints William J. Fitzgerald, Christopher McCain
and Mark Allen, and each of them, with full power to act without the others,
his true and lawful attorney-in-fact, with full power of substitution, to sign
any and all instruments, certificates and documents that may be necessary,
desirable or appropriate to be executed on behalf of himself as an individual
or in his capacity as a direct or indirect general partner, director, officer or
manager of any partnership, corporation or limited liability company, pursuant
to section 13 or 16 of the Securities Exchange Act of 1934, as amended (the
"Exchange Act"), and any and all regulations promulgated thereunder, and to
file the same, with all exhibits thereto, and any other documents in connection
therewith, with the Securities and Exchange Commission, and with any other
entity when and if such is mandated by the Exchange Act or by the Financial
Industry Regulatory Authority, granting unto said attorney-in-fact full power
and authority to do and perform each and every act and thing necessary, desirable
or appropriate, fully to all intents and purposes as he might or could do in
person, thereby ratifying and confirming all that said attorney-in-fact, or his
substitutes, may lawfully do or cause to be done by virtue hereof. This Power of
Attorney shall remain in full force and effect with respect to each undersigned
person unless and until six months after such person is both no longer a Managing
Director of General Catalyst Partners and no longer serving on the board of
directors of any portfolio company of any General Catalyst Partners fund.
IN WITNESS WHEREOF, this Power of Attorney has been signed as of the 7th
day of October, 2014.
/s/ Lawrence S. Bohn
Lawrence S. Bohn
/s/ Joel E. Cutler
Joel E. Cutler
/s/ David P. Fialkow
David P. Fialkow
/s/ William J. Fitzgerald
William J. Fitzgerald
/s/ Stephen A. Herrod
Stephen A. Herrod
/s/ David J. Orfao
David J. Orfao
/s/ Neil F. Sequeira
Neil F. Sequeira
/s/ Brian J. Shortsleeve
Brian J. Shortsleeve
/s/ Hemant Taneja
Hemant Taneja
/s/ Adam A. Valkin
Adam A. Valkin