Sec Form 3 Filing - Cessna Tina @ Backblaze, Inc. - 2023-04-13

Insider filing report for Changes in Beneficial Ownership
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FORM 3
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
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Cessna Tina
2. Issuer Name and Ticker or Trading Symbol
Backblaze, Inc. [ BLZE]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Senior VP, Engineering
(Last) (First) (Middle)
500 BEN FRANKLIN CT
3. Date of Earliest Transaction (MM/DD/YY)
04/13/2023
(Street)
SAN MATEO, CA94401
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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
Class A Common Stock 100,557 ( 1 ) D
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 (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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
Stock Option (right to buy) $ 2.54 ( 2 ) 10/17/2028 Class A Common Stock 105,279 D
Stock Option (right to buy) $ 2.61 ( 3 ) 10/27/2029 Class A Common Stock 25,560 D
Stock Option (right to buy) $ 3.73 ( 4 ) 12/09/2030 Class A Common Stock 32,760 D
Stock Option (right to buy) $ 8.09 ( 5 ) 06/27/2031 Class A Common Stock 50,039 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Cessna Tina
500 BEN FRANKLIN CT
SAN MATEO, CA94401
Senior VP, Engineering
Signatures
Thomas L. MacMitchell, Attorney-in-Fact 05/24/2023
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Includes (i) 19,256 shares of Class A common stock and (ii) 81,301 Restricted Stock Units ("RSUs") which represent a contingent right to receive one share of Class A common stock for each RSU. The RSUs are subject to a service-based vesting requirement, which shall be satisfied over a three-year period. 6.25% of the RSUs vested on May 20, 2023 and 6.25% of the RSUs shall vest each quarter thereafter, subject to the Reporting Person's continuous service with the issuer.
( 2 )The options are fully vested.
( 3 )The options are subject to a service-based vesting requirement, which shall be satisfied over a four-year period. 25% of the options vested on June 10, 2020 and 1/48th of the options vest monthly thereafter, subject to the Reporting Person's continuous service with the issuer. The options are exercisable into shares of Class B common stock, which are convertible on a one-to-one basis into shares of Class A common stock at the option of the holder.
( 4 )The options are subject to a service-based vesting requirement, which shall be satisfied over a four-year period. 25% of the options vested on June 25, 2021 and 1/48th of the options vest monthly thereafter, subject to the Reporting Person's continuous service with the issuer. The options are exercisable into shares of Class B common stock, which are convertible on a one-to-one basis into shares of Class A common stock at the option of the holder.
( 5 )The options are subject to a service-based vesting requirement, which shall be satisfied over a four-year period. 25% of the options vested on June 25, 2022 and 1/48th of the options vest monthly thereafter, subject to the Reporting Person's continuous service with the issuer. The options are exercisable into shares of Class B common stock, which are convertible on a one-to-one basis into shares of Class A common stock at the option of the holder.

Remarks:
Exhibit 24 - Power of Attorney

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