Sec Form 3 Filing - Gupta Ravi @ Maplebear Inc. - 2023-09-22

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
Gupta Ravi
2. Issuer Name and Ticker or Trading Symbol
Maplebear Inc. [ CART]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
50 BEALE STREET, SUITE 600
3. Date of Earliest Transaction (MM/DD/YY)
09/22/2023
(Street)
SAN FRANCISCO, CA94105
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
Common Stock 4,405,162 I Sequoia Capital Global Growth Fund II, L.P. ( 1 ) ( 2 ) ( 3 )
Common Stock 68,020 I Sequoia Capital Global Growth II Principals Fund, L.P. ( 1 ) ( 2 ) ( 3 )
Common Stock 351,374 I Sequoia Capital Global Growth Fund III - Endurance Partners, L.P. ( 1 ) ( 2 ) ( 3 )
Common Stock 25,726,519 I Sequoia Capital USV XIV Holdco, Ltd. ( 1 ) ( 2 ) ( 3 )
Common Stock 4,744,206 I Sequoia Capital U.S. Growth Fund VI, L.P. ( 1 ) ( 2 ) ( 3 )
Common Stock 308,013 I Sequoia Capital U.S. Growth VI Principals Fund, L.P. ( 1 ) ( 2 ) ( 3 )
Common Stock 1,774,756 I Sequoia Capital U.S. Growth Fund VII, L.P. ( 1 ) ( 2 ) ( 3 )
Common Stock 164,955 I Sequoia Capital U.S. Growth VII Principals Fund, L.P. ( 1 ) ( 2 ) ( 3 )
Common Stock 1,217,532 I SCGGF III - U.S./India Management, L.P. ( 1 ) ( 2 ) ( 3 )
Common Stock 1,000,000 I Sequoia Capital US/E Expansion Fund I, L.P. ( 1 ) ( 2 ) ( 3 )
Common Stock 12,393,305 I Sequoia Grove II, LLC ( 4 )
Common Stock 14,185 I Sequoia Grove UK, L.P. ( 4 )
Common Stock 905,382 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
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Gupta Ravi
50 BEALE STREET
SUITE 600
SAN FRANCISCO, CA94105
X X
Signatures
By: /s/ Jung Yeon Son, by power of attorney for Ravi Gupta 09/26/2023
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The Reporting Person is a director and stockholder of SC US (TTGP), Ltd. SC US (TTGP), Ltd. is (i) the general partner of SC U.S. Venture XIV Management, L.P., which is the general partner of each of Sequoia Capital U.S. Venture Fund XIV, L.P., Sequoia Capital U.S. Venture Partners Fund XIV, L.P., and Sequoia Capital U.S. Venture Partners Fund XIV (Q), L.P., or collectively, the XIV Funds, which together own 100% of the outstanding ordinary shares of Sequoia Capital USV XIV Holdco, Ltd., or XIV Holdco; (ii) the general partner of SC U.S. Growth VI Management, L.P., which is the general partner of each of Sequoia Capital U.S. Growth Fund VI, L.P., and Sequoia Capital U.S. Growth VI Principals Fund, L.P., or collectively, the GF VI Funds; (iii) the general partner of SC U.S. Growth VII Management, L.P., which is the general partner of each of Sequoia Capital U.S. Growth Fund VII, L.P., and Sequoia Capital U.S. Growth VII Principals Fund, L.P., or collectively, the GF VII Funds;
( 2 )(Continue from Footnote 1) (iv) the general partner of SC Global Growth II Management, L.P., which is the general partner of each of Sequoia Capital Global Growth Fund II, L.P., and Sequoia Capital Global Growth II Principals Fund, L.P., or collectively, the GGF II Funds; (v) the general partner of SCGGF III - Endurance Partners Management, L.P., which is the general partner of Sequoia Capital Global Growth Fund III - Endurance Partners, L.P., or GGF III; (vi) the general partner of SCGGF III - U.S./India Management, L.P., or GGF III US IND MGMT; and (vii) the general partner of SC US/E Expansion Fund I Management, L.P., which is the general partner of Sequoia Capital US/E Expansion Fund I, L.P., or EXP I.
( 3 )(Continued from Footnote 2) As a result, the Reporting Person may be deemed to share beneficial ownership of the shares held by XIV Holdco, the GF VI Funds, the GF VII Funds, the GGF II Funds, GGF III, GGF III US IND MGMT and EXP I. The Reporting Person disclaims beneficial ownership of the securities included in this report, except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.
( 4 )The Reporting Person is a member of Sequoia Grove II, LLC. The Reporting Person disclaims beneficial ownership of the securities included in this report except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.

Remarks:
Exhibit 24.1 - Power of Attorney

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