Sec Form 13G Filing - Mehta Apoorva filing for Maplebear Inc. (CART) - 2024-02-14

The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

 Names of Reporting Persons.

 Apoorva Mehta

 Check the Appropriate Box if a Member of a Group (See Instructions)

 (a) ☐  (b) ☒

 SEC Use Only

 Citizenship or Place of Organization

 Canada

Number of

Shares  Beneficially 

Owned by

Each

Reporting

Person

With:

 Sole Voting Power

 28,280,677 shares (1)

 Shared Voting Power

 0

 Sole Dispositive Power

 28,280,677 shares (1)

 Shared Dispositive Power

 0

 Aggregate Amount Beneficially Owned by Each Reporting Person

 28,280,677 shares (1)

 Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)

 ☐

 Percent of Class Represented by Amount in Row (9)

 9.9% (2)

 Type of Reporting Person (See Instructions)

 IN

As of December 31, 2023, consists of (i) 4,141 shares of Common Stock, par value $0.0001 per share (“Common Stock”), of Maplebear Inc. (the “Company”) held by Mr. Mehta directly, (ii) 23,409,751 shares of Common Stock held by The Apoorva Mehta Revocable Trust, dated June 20, 2018, of which Mr. Mehta is trustee and has sole voting and dispositive power, and (iii) 4,866,785 shares of Common Stock subject to stock options that are exercisable within 60 days of December 31, 2023.

Percentage ownership is based on 280,215,950 shares of Common Stock outstanding as of October 31, 2023, as reported in the Company’s Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on November 13, 2023, plus the assumed exercise, solely for purposes of calculating Mr. Mehta’s percentage ownership, of the stock options to which 4,866,785 shares of Common Stock beneficially owned by Mr. Mehta are subject as described herein.

Name of Issuer:

Address of Issuer’s Principal Executive Offices:

Name of Person Filing:

Address of Principal Business Office or, if none, Residence:

Citizenship:

Title of Class of Securities:

CUSIP Number:

If this statement is filed pursuant to §§240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:

Ownership.

Amount beneficially owned:

Percent of class:

Number of shares as to which the person has:

Sole power to vote or to direct the vote:

Shared power to vote or to direct the vote:

Sole power to dispose or to direct the disposition of:

Shared power to dispose or to direct the disposition of:

Ownership of 5 Percent or Less of a Class.

Ownership of More than 5 Percent on Behalf of Another Person.

Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person.

Identification and Classification of Members of the Group.

Notice of Dissolution of Group.

Certifications.