# EDGAR Filing Document

**Accession Number:** 0001720671
**File Stem:** 0001209191-23-018902
**Filing Date:** 2023-3
**Character Count:** 11890
**Document Hash:** f9416f8a1b2cf36344fe4b84f1ec7e48
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001209191-23-018902.hdr.sgml**: 20230315

**ACCESSION NUMBER**: 0001209191-23-018902

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230313

**FILED AS OF DATE**: 20230315

**DATE AS OF CHANGE**: 20230315

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** GGV Capital V L.P.
- **CENTRAL INDEX KEY:** 0001605612
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41121
- **FILM NUMBER:** 23735453

**BUSINESS ADDRESS:**
- **STREET 1:** 2494 SAND HILL ROAD, SUITE 100, BLDG. 7
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
- **BUSINESS PHONE:** (650) 475-2150

**MAIL ADDRESS:**
- **STREET 1:** 2494 SAND HILL ROAD, SUITE 100, BLDG. 7
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** GGV Capital V L.L.C.
- **CENTRAL INDEX KEY:** 0001766305
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41121
- **FILM NUMBER:** 23735454

**BUSINESS ADDRESS:**
- **STREET 1:** 3000 SAND HILL ROAD
- **STREET 2:** BUILDING 4, SUITE 230
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
- **BUSINESS PHONE:** 650-475-2131

**MAIL ADDRESS:**
- **STREET 1:** 3000 SAND HILL ROAD
- **STREET 2:** BUILDING 4, SUITE 230
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** GGV Capital V Entrepreneurs Fund L.P.
- **CENTRAL INDEX KEY:** 0001605614
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41121
- **FILM NUMBER:** 23735452

**BUSINESS ADDRESS:**
- **STREET 1:** 2494 SAND HILL ROAD, SUITE 100, BLDG. 7
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
- **BUSINESS PHONE:** (650) 475-2150

**MAIL ADDRESS:**
- **STREET 1:** 2494 SAND HILL ROAD, SUITE 100, BLDG. 7
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** HashiCorp, Inc.
- **CENTRAL INDEX KEY:** 0001720671
- **STANDARD INDUSTRIAL CLASSIFICATION:** SERVICES-COMPUTER PROGRAMMING SERVICES [7371]
- **IRS NUMBER:** 320410665
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 0131

**BUSINESS ADDRESS:**
- **STREET 1:** 101 2ND STREET, SUITE 700
- **CITY:** SAN FRANCISCO
- **STATE:** CA
- **ZIP:** 94105
- **BUSINESS PHONE:** 415-301-3227

**MAIL ADDRESS:**
- **STREET 1:** 101 2ND STREET, SUITE 700
- **CITY:** SAN FRANCISCO
- **STATE:** CA
- **ZIP:** 94105

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>GGV Capital V L.L.C.<br><sub>(Last) (First) (Middle)</sub><br>3000 SAND HILL ROAD<br>BUILDING 4, SUITE 230<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-13 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>HashiCorp, Inc. [ HCP ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>GGV Capital V L.P.<br><sub>(Last) (First) (Middle)</sub><br>3000 SAND HILL ROAD<br>BUILDING 4, SUITE 230<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-13 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>HashiCorp, Inc. [ HCP ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>GGV Capital V Entrepreneurs Fund L.P.<br><sub>(Last) (First) (Middle)</sub><br>3000 SAND HILL ROAD<br>BUILDING 4, SUITE 230<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-13 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>HashiCorp, Inc. [ HCP ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Class A Common Stock | 2023-03-13 |  | C |  | 2098692 | A | 0.00<sup>(1)</sup> | 2098692 | I | By GGV Capital V L.P.<sup>(2)</sup> |
| Class A Common Stock | 2023-03-13 |  | C |  | 77022 | A | 0.00<sup>(1)</sup> | 77022 | I | By GGV Capital V Entrepreneurs Fund L.P.<sup>(3)</sup> |
| Class A Common Stock | 2023-03-13 |  | J<sup>(4)</sup> |  | 2098692 | D | $0.00 | 0 | I | By GGV Capital V L.P.<sup>(2)</sup> |
| Class A Common Stock | 2023-03-13 |  | J<sup>(5)</sup> |  | 77022 | D | $0.00 | 0 | I | By GGV Capital V Entrepreneurs Fund L.P.<sup>(3)</sup> |
| Class A Common Stock | 2022-12-19 |  | J<sup>(6)</sup> |  | 457974 | A | $0.00 | 599129 | D<sup>(7)</sup> |  |
| Class A Common Stock | 2022-12-19 |  | J<sup>(8)</sup> |  | 401513 | D | $0.00 | 197616 | D<sup>(7)</sup> |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Class B Common Stock | <sup>(1)</sup> | 2023-03-13 |  | C |  |  | 2098692 | <sup>(9)</sup> | <sup>(9)</sup> | Class A Common Stock | 2098692 | <sup>(9)</sup> | 13641500 | I | By GGV Capital V L.P.<sup>(2)</sup> |
| Class B Common Stock | <sup>(1)</sup> | 2023-03-13 |  | C |  |  | 77022 | <sup>(9)</sup> | <sup>(9)</sup> | Class A Common Stock | 77022 | <sup>(9)</sup> | 500643 | I | By GGV Capital V Entrepreneurs Fund L.P.<sup>(3)</sup> |

---

### Footnotes:

(1) Each share of Class B Common Stock was converted into one share of Class A Common Stock for no additional consideration at the option of the Reporting Person and had no expiration date.

(2) The shares are held of record by GGV Capital V L.P. ("GGV V LP"). GGV Capital V L.L.C. ("GGV V LLC") serves as the general partner of GGV V LP and may be deemed to have voting and dispositive power over the shares held by GGV V LP. GGV V LLC disclaims beneficial ownership of such shares, except to the extent of its proportionate pecuniary interest therein.

(3) The shares are held of record by GGV Capital V Entrepreneurs Fund L.P. ("GGV Entrepreneurs"). GGV V LLC serves as the general partner of GGV Entrepreneurs and may be deemed to have voting and dispositive power over the shares held by GGV Entrepreneurs. GGV V LLC disclaims beneficial ownership of such shares, except to the extent of its proportionate pecuniary interest therein.

(4) Represents a pro rata, in-kind distribution, and not a purchase or sale of securities, by GGV V LP to its general partner and limited partners without additional consideration.

(5) Represents a pro rata, in-kind distribution, and not a purchase or sale of securities, by GGV Entrepreneurs to its limited partners without additional consideration.

(6) Represents receipt of shares in the distribution in kind described in footnote (4).

(7) The shares are held of record by GGV V LLC.

(8) Represents a pro rata, in-kind distribution, and not a purchase or sale of securities, by GGV V LLC to its members without additional consideration.

(9) Each share of Class B Common Stock is convertible at any time into Class A Common Stock on a one-to-one basis at the Reporting Person's election and has no expiration date.

**Signature:** GGV Capital V L.L.C., by /s/ Glenn Solomon, Managing Director  
**Date:** 2023-03-15

**Signature:** GGV Capital V L.P., by GGV Capital V L.L.C., its General Partner, by /s/ Glenn Solomon, Managing Director  
**Date:** 2023-03-15

**Signature:** GGV Capital V Entrepreneurs Fund L.P., by GGV Capital V L.L.C., its General Partner, by /s/ Glenn Solomon, Managing Director  
**Date:** 2023-03-15

### Remarks:

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.**