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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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*
Institutional Venture Management XV, LLC

(Last) (First) (Middle)
3000 SAND HILL ROAD BLDG. 2, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Lulu's Fashion Lounge Holdings, Inc. [ LVLU ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
09/16/2022
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction 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
Common Stock 09/16/2022 J(1) 3,262 A (1) 3,262 D(2)
Common Stock 09/16/2022 J(1) 3,260 A (1) 3,260 I Directly held by Institutional Venture Management XVI, LLC(3)
Common Stock 3,730,160 I Directly held by Institutional Venture Partners XV, L.P.(4)
Common Stock 19,843 I Directly held by Institutional Venture Partners XV Executive Fund, L.P.(5)
Common Stock 3,749,997 I Directly held by Institutional Venture Partners XVI, L.P.(6)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction 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 (Month/Day/Year) 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: 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
1. Name and Address of Reporting Person*
Institutional Venture Management XV, LLC

(Last) (First) (Middle)
3000 SAND HILL ROAD BLDG. 2, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Institutional Venture Management XVI, LLC

(Last) (First) (Middle)
3000 SAND HILL ROAD BLDG. 2, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Chaffee Todd C

(Last) (First) (Middle)
3000 SAND HILL ROAD, BLDG. 2, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Dash Somesh

(Last) (First) (Middle)
300 SAND HILL ROAD, BLDG. 2, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
FOGELSONG NORMAN A

(Last) (First) (Middle)
300 SAND HILL ROAD, BLDG. 2, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Harrick Stephen J

(Last) (First) (Middle)
300 SAND HILL ROAD, BLDG. 2, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Maltz Jules A.

(Last) (First) (Middle)
300 SAND HILL ROAD, BLDG. 2, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Miller J Sanford

(Last) (First) (Middle)
300 SAND HILL ROAD, BLDG. 2, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Phelps Dennis B

(Last) (First) (Middle)
3000 SAND HILL ROAD, BLDG. 2, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
Explanation of Responses:
1. Represents the receipt of shares from Eric Liaw that Mr. Liaw received pursuant to the Issuer's non-employee director compensation policy. Pursuant to a series of Director Compensation Assignment Agreements, the Mr. Liaw has agreed to assign the beneficial interest in any equity awards granted to him for his service as director of the Issuer to Institutional Venture Management XV, LLC ("IVM XV") and Institutional Venture Management XVI, LLC ("IVM XVI").
2. Todd C. Chaffee, Somesh Dash, Norman A. Fogelsong, Stephen J. Harrick, Jules A. Maltz, J. Sanford Miller and Dennis B. Phelps (collectively, the "Managing Directors") and Eric Liaw are the managing directors of IVM XV and may be deemed to share voting and dispositive power over the shares held by IVM XV. Each of the Managing Directors disclaim beneficial ownership of the shares held by IVM XV except to the extent of his respective proportionate pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports.
3. The Managing Directors and Eric Liaw are the managing directors of IVM XVI and may be deemed to share voting and dispositive power over the shares held by IVM XVI. Each of the Managing Directors disclaims beneficial ownership of these securities, except to the extent of his respective proportionate pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports.
4. IVM XV is the general partner of Institutional Venture Partners XV, L.P. ("IVP XV"). The Managing Directors and Eric Liaw are the managing directors of IVM XV and may be deemed to share voting and dispositive power over the shares held by IVP XV. Each of the Managing Directors disclaims beneficial ownership of the shares held by IVP XV except to the extent of his pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports.
5. IVM XV is the general partner of Institutional Venture Partners XV Executive Fund, L.P. ("IVP XV EF"). The Managing Directors and Eric Liaw are the managing directors of IVM XV and may be deemed to share voting and dispositive power over the shares held by IVP XV EF. Each of the Managing Directors disclaims beneficial ownership of the shares held by IVP XV EF except to the extent of his pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports.
6. IVM XVI is the general partner of Institutional Venture Partners XVI, L.P. ("IVP XVI"). The Managing Directors and Eric Liaw are the managing directors of IVM XVI and may be deemed to share voting and dispositive power over the shares held by IVP XVI. Each of the Managing Directors disclaims beneficial ownership of the shares held by IVP XVI except to the extent of his pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports.
Remarks:
Institutional Venture Management XV, LLC, By: /s/Tracy Hogan, Attorney-In-Fact 09/20/2022
Institutional Venture Management XVI, LLC, By: /s/Tracy Hogan, Attorney-In-Fact 09/20/2022
/s/ Tracy Hogan, Attorney-In-Fact Todd C. Chaffee 09/20/2022
/s/ Tracy Hogan, Attorney-In-Fact Somesh Dash 09/20/2022
/s/ Tracy Hogan, Attorney-In-Fact Norman A. Fogelsong 09/20/2022
/s/ Tracy Hogan, Attorney-In-Fact Stephen J. Harrick 09/20/2022
/s/ Tracy Hogan, Attorney-In-Fact Jules A. Maltz 09/20/2022
/s/ Tracy Hogan, Attorney-In-Fact Sanford J. Miller 09/20/2022
/s/ Tracy Hogan, Attorney-In-Fact Dennis B. Phelps 09/20/2022
** Signature of Reporting Person Date
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