# EDGAR Filing Document

**Accession Number:** 0001359524
**File Stem:** 0001209191-23-020353
**Filing Date:** 2023-3
**Character Count:** 19525
**Document Hash:** d78ffdaa332ec1c25d73d617ee8d300b
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001209191-23-020353.hdr.sgml**: 20230321

**ACCESSION NUMBER**: 0001209191-23-020353

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230317

**FILED AS OF DATE**: 20230321

**DATE AS OF CHANGE**: 20230321

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** FOGELSONG NORMAN A
- **CENTRAL INDEX KEY:** 0001140932

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41059
- **FILM NUMBER:** 23750640

**MAIL ADDRESS:**
- **STREET 1:** C/O IVP
- **STREET 2:** 3000 SAND HILL ROAD, 2-250
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Phelps Dennis B
- **CENTRAL INDEX KEY:** 0001299965

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41059
- **FILM NUMBER:** 23750636

**MAIL ADDRESS:**
- **STREET 1:** 3000 SAND HILL ROAD
- **STREET 2:** 2-250
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Harrick Stephen J
- **CENTRAL INDEX KEY:** 0001299975

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41059
- **FILM NUMBER:** 23750639

**MAIL ADDRESS:**
- **STREET 1:** 3000 SAND HILL ROAD
- **STREET 2:** 2-250
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Chaffee Todd C
- **CENTRAL INDEX KEY:** 0001300134

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41059
- **FILM NUMBER:** 23750642

**MAIL ADDRESS:**
- **STREET 1:** 3000 SAND HILL ROAD
- **STREET 2:** 2-250
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Dash Somesh
- **CENTRAL INDEX KEY:** 0001843938

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41059
- **FILM NUMBER:** 23750641

**MAIL ADDRESS:**
- **STREET 1:** 3000 SAND HILL ROAD
- **STREET 2:** BUILDING 2, SUITE 250
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Maltz Jules A.
- **CENTRAL INDEX KEY:** 0001553254

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41059
- **FILM NUMBER:** 23750638

**MAIL ADDRESS:**
- **STREET 1:** 3000 SAND HILL ROAD
- **STREET 2:** BUILDING 2, SUITE 250
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Institutional Venture Management XV, LLC
- **CENTRAL INDEX KEY:** 0001640275
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41059
- **FILM NUMBER:** 23750643

**BUSINESS ADDRESS:**
- **STREET 1:** 3000 SAND HILL ROAD
- **STREET 2:** BUILDING 2, SUITE 250
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
- **BUSINESS PHONE:** 650 854 0132

**MAIL ADDRESS:**
- **STREET 1:** 3000 SAND HILL ROAD
- **STREET 2:** BUILDING 2, SUITE 250
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Miller J Sanford
- **CENTRAL INDEX KEY:** 0001359524

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41059
- **FILM NUMBER:** 23750637

**MAIL ADDRESS:**
- **STREET 1:** 3000 SAND HILL ROAD
- **STREET 2:** BUILDING 2, SUITE 250
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025

**FORMER NAME:**
- **FORMER CONFORMED NAME:** Miller J Sanford (Sandy)
- **DATE OF NAME CHANGE:** 20060414
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Lulu's Fashion Lounge Holdings, Inc.
- **CENTRAL INDEX KEY:** 0001780201
- **STANDARD INDUSTRIAL CLASSIFICATION:** RETAIL-CATALOG & MAIL-ORDER HOUSES [5961]
- **IRS NUMBER:** 208442468
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 0101

**BUSINESS ADDRESS:**
- **STREET 1:** 195 HUMBOLDT AVENUE
- **CITY:** CHICO
- **STATE:** CA
- **ZIP:** 95928
- **BUSINESS PHONE:** 530-343-3545

**MAIL ADDRESS:**
- **STREET 1:** 195 HUMBOLDT AVENUE
- **CITY:** CHICO
- **STATE:** CA
- **ZIP:** 95928

### 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>Institutional Venture Management XV, LLC<br><sub>(Last) (First) (Middle)</sub><br>3000 SAND HILL ROAD BLDG. 2, SUITE 250<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-17 | **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>Lulu's Fashion Lounge Holdings, Inc. [ LVLU ] | **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>Chaffee Todd C<br><sub>(Last) (First) (Middle)</sub><br>3000 SAND HILL ROAD, BLDG. 2, SUITE 250<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-17 | **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>Lulu's Fashion Lounge Holdings, Inc. [ LVLU ] | **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>Dash Somesh<br><sub>(Last) (First) (Middle)</sub><br>300 SAND HILL ROAD, BLDG. 2, SUITE 250<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-17 | **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>Lulu's Fashion Lounge Holdings, Inc. [ LVLU ] | **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>FOGELSONG NORMAN A<br><sub>(Last) (First) (Middle)</sub><br>300 SAND HILL ROAD, BLDG. 2, SUITE 250<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-17 | **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>Lulu's Fashion Lounge Holdings, Inc. [ LVLU ] | **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>Harrick Stephen J<br><sub>(Last) (First) (Middle)</sub><br>300 SAND HILL ROAD, BLDG. 2, SUITE 250<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-17 | **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>Lulu's Fashion Lounge Holdings, Inc. [ LVLU ] | **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>Maltz Jules A.<br><sub>(Last) (First) (Middle)</sub><br>300 SAND HILL ROAD, BLDG. 2, SUITE 250<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-17 | **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>Lulu's Fashion Lounge Holdings, Inc. [ LVLU ] | **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>Miller J Sanford<br><sub>(Last) (First) (Middle)</sub><br>300 SAND HILL ROAD, BLDG. 2, SUITE 250<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-17 | **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>Lulu's Fashion Lounge Holdings, Inc. [ LVLU ] | **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>Phelps Dennis B<br><sub>(Last) (First) (Middle)</sub><br>3000 SAND HILL ROAD, BLDG. 2, SUITE 250<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-17 | **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>Lulu's Fashion Lounge Holdings, Inc. [ LVLU ] | **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 |
| Common Stock | 2023-03-17 |  | J<sup>(1)</sup> |  | 9383 | A | <sup>(1)</sup> | 13863 | D<sup>(2)</sup> |  |
| Common Stock |  |  |  |  |  |  |  | 4479 | I | By Institutional Venture Management XVI, LLC<sup>(3)</sup> |
| Common Stock |  |  |  |  |  |  |  | 3730160 | I | By Institutional Venture Partners XV, L.P.<sup>(4)</sup> |
| Common Stock |  |  |  |  |  |  |  | 19843 | I | By Institutional Venture Partners XV Executive Fund, L.P.<sup>(5)</sup> |
| Common Stock |  |  |  |  |  |  |  | 3749997 | I | By Institutional Venture Partners XVI, L.P.<sup>(6)</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 |
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

---

### Footnotes:

(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, 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").

(2) Todd C. Chaffee, Somesh Dash, Norman A. Fogelsong, Eric Liaw, Stephen J. Harrick, Jules A. Maltz, J. Sanford Miller and Dennis B. Phelps 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 Messrs. Chaffee, Dash, Fogelsong, Harrick, Maltz, Miller and Phelps disclaims 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 shares are held directly by Institutional Venture Management XVI, LLC ("IVM XVI"). Todd C. Chaffee, Somesh Dash, Norman A. Fogelsong, Stephen J. Harrick, Eric Liaw, Jules A. Maltz, J. Sanford Miller and Dennis B. Phelps, Jr. 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 Messrs. Chaffee, Dash, Fogelsong, Harrick, Maltz, Miller and Phelps 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) The shares are held directly by Institutional Venture Partners XV, L.P. ("IVP XV"). IVM XV is the general partner of IVP XV. Todd C. Chaffee, Somesh Dash, Norman A. Fogelsong, Eric Liaw, Stephen J. Harrick, Jules A. Maltz, J. Sanford Miller and Dennis B. Phelps 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 IVM XV and Messrs. Chaffee, Dash, Fogelsong, Harrick, Maltz, Miller and Phelps disclaims beneficial ownership of the shares held by IVP XV except to the extent of its or his respective proportionate pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports.

(5) The shares are held directly by Institutional Venture Partners XV Executive Fund, L.P. ("IVP XV EF"). IVM XV is the general partner of IVP XV EF.  Todd C. Chaffee, Somesh Dash, Norman A. Fogelsong, Eric Liaw, Stephen J. Harrick, Jules A. Maltz, J. Sanford Miller and Dennis B. Phelps 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 IVM XV and Messrs. Chaffee, Dash, Fogelsong, Harrick, Maltz, Miller and Phelps disclaims beneficial ownership of the shares held by IVP XV EF except to the extent of its or his respective proportionate pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports.

(6) The shares are held directly by Institutional Venture Partners XVI, L.P. ("IVP XVI"). IVM XVI is the general partner of IVP XVI. Todd C. Chaffee, Somesh Dash, Norman A. Fogelsong, Eric Liaw, Stephen J. Harrick, Jules A. Maltz, J. Sanford Miller and Dennis B. Phelps 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 IVM XVI and Messrs. Chaffee, Dash, Fogelsong, Harrick, Maltz, Miller and Phelps disclaims beneficial ownership of the shares held by IVP XVI except to the extent of its or his respective proportionate pecuniary interest therein. Mr. Liaw is a director of the Issuer and files separate Section 16 reports.

**Signature:** Institutional Venture Management XV, LLC, By: /s/Tracy Hogan, Attorney-In-Fact  
**Date:** 2023-03-21

**Signature:** /s/ Tracy Hogan, Attorney-In-Fact Todd C. Chaffee  
**Date:** 2023-03-21

**Signature:** /s/ Tracy Hogan, Attorney-In-Fact Somesh Dash  
**Date:** 2023-03-21

**Signature:** /s/ Tracy Hogan, Attorney-In-Fact Norman A. Fogelsong  
**Date:** 2023-03-21

**Signature:** /s/ Tracy Hogan, Attorney-In-Fact Stephen J. Harrick  
**Date:** 2023-03-21

**Signature:** /s/ Tracy Hogan, Attorney-In-Fact Jules A. Maltz  
**Date:** 2023-03-21

**Signature:** /s/ Tracy Hogan, Attorney-In-Fact Sanford J. Miller  
**Date:** 2023-03-21

**Signature:** /s/ Tracy Hogan, Attorney-In-Fact Dennis B. Phelps  
**Date:** 2023-03-21

### 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.**