Sec Form 3 Filing - BOTHA ROELOF @ Ethos Technologies Inc. - 2026-01-28

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
BOTHA ROELOF
2. Issuer Name and Ticker or Trading Symbol
Ethos Technologies Inc. [ LIFE]
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)
2800 SAND HILL ROAD, SUITE 101
3. Date of Earliest Transaction (MM/DD/YY)
01/28/2026
(Street)
MENLO PARK, CA94025
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
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
Series A-2 Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 63,370 I Nalrena, L.L.C ( 4 )
Series A-2 Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 79,246 I Spelunker Channel Holdings, LLC ( 4 )
Series A-2 Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 1,897,656 I Sequoia Capital U.S. Venture Fund XV, L.P. ( 3 )
Series A-2 Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 79,975 I Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P. ( 3 )
Series A-2 Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 28,725 I Sequoia Capital U.S. Venture Partners Fund XV, L.P. ( 3 )
Series A-2 Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 291,875 I Sequoia Capital U.S. Venture XV Principals Fund, L.P. ( 3 )
Series A Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 4,767,653 I Sequoia Capital U.S. Venture Fund XV, L.P. ( 3 )
Series A Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 200,936 I Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P. ( 3 )
Series A Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 72,174 I Sequoia Capital U.S. Venture Partners Fund XV, L.P. ( 3 )
Series A Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 733,307 I Sequoia Capital U.S. Venture XV Principals Fund, L.P. ( 3 )
Series B Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 1,124,709 I Sequoia Capital U.S. Venture Fund XV, L.P. ( 3 )
Series B Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 47,400 I Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P. ( 3 )
Series B Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 17,025 I Sequoia Capital U.S. Venture Partners Fund XV, L.P. ( 3 )
Series B Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 172,989 I Sequoia Capital U.S. Venture XV Principals Fund, L.P. ( 3 )
Series C Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 180,988 I Sequoia Capital U.S. Venture Fund XV, L.P. ( 3 )
Series C Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 7,627 I Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P. ( 3 )
Series C Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 2,739 I Sequoia Capital U.S. Venture Partners Fund XV, L.P. ( 3 )
Series C Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 27,837 I Sequoia Capital U.S. Venture XV Principals Fund, L.P. ( 3 )
Series C Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 1,917,944 I Sequoia Capital U.S. Growth Fund VIII, L.P. ( 3 )
Series D Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 56,275 I Sequoia Capital U.S. Venture Fund XV, L.P. ( 3 )
Series D Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 2,058 I Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P. ( 3 )
Series D Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 878 I Sequoia Capital U.S. Venture Partners Fund XV, L.P. ( 3 )
Series D Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 12,274 I Sequoia Capital U.S. Venture XV Principals Fund, L.P. ( 3 )
Series D Preferred Stock ( 1 ) ( 1 ) ( 2 ) Class A Common Stock 214,464 I Sequoia Capital U.S. Growth Fund VIII, L.P. ( 3 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
BOTHA ROELOF
2800 SAND HILL ROAD, SUITE 101
MENLO PARK, CA94025
X X
Signatures
/s/ Jung Yeon Son, Attorney-in-fact for Roelof Botha 01/28/2026
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The Series A-2, Series A, Series B, Series C, and Series D Preferred Stock are each convertible into Class A Common Stock on a ratio dependent on the public offering price of the Class A Common Stock in the Issuer's initial public offering (IPO). Upon the closing of the Issuer's IPO, all shares of Series A-2, Series A, Series B, Series C, and Series D Preferred Stock will be automatically converted into shares of Class A Common Stock of the Issuer (the "Class A Conversion"). Immediately following the Class A Conversion, each share of the Class A Common Stock shall be exchanged at a 1:1 ratio for shares of Class B Common Stock. Each share of Class B Common Stock is convertible at the option of the holder thereof into one share of Class A Common Stock and otherwise in accordance with the terms of the Issuer's Certificate of Incorporation.
( 2 )Each share of the Series A-2, Series A, Series B, Series C, and Series D Preferred Stock has no expiration date.
( 3 )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. Growth VIII Management, L.P., which is the general partner of Sequoia Capital U.S. Growth Fund VIII, L.P. (GFVIII), and (ii) the general partner of SC U.S. Venture XV Management, L.P., which is the general partner of Sequoia Capital U.S. Venture Fund XV, L.P., Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P., Sequoia Capital U.S. Venture Partners Fund XV, L.P., and Sequoia Capital U.S. Venture XV Principals Fund, L.P. (collectively, the XV Funds). The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed to be 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 director and stockholder of SC US SSF 2013 (TTGP), L.L.C. SC US SSF 2013 (TTGP), L.L.C. is the general partner of SC U.S. Scout Seed Fund 2013 Management, L.P., which is the general partner of Sequoia Capital U.S. Scout Seed Fund 2013, L.P., which wholly owns Sequoia Capital U.S. Scout Fund IV, L.L.C., which in turn wholly owns Nalrena, L.L.C. and Spelunker Channel Holdings, LLC (collectively, the Scout Funds). The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed to be an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.

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