Ibotta, Inc. — Director's Dealing 2024

Apr 18, 2024

SEC Form 3 — Initial Statement of Beneficial Ownership

Issuer: Ibotta, Inc. (IBTA)
CIK: 0001538379
Period of Report: 2024-04-17

Reporting Person: Clark Jermoluk Founders Fund I LLC (N/A)
Reporting Person: CLARK JAMES H (10% Owner)

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Series B Preferred Stock	$		Common Stock (3520804)		Direct
Series C Preferred Stock	$		Common Stock (1862545)		Direct
Series C-1 Preferred Stock	$		Common Stock (379108)		Direct

Footnotes

F1: Each share of Series B Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock (the "IPO") and has no expiration date.

F2: Each share of Common Stock shall be reclassified into one share of Class A Common Stock immediately prior to the completion of the IPO.

F3: The shares are held by Clark Jermoluk Founders Fund I LLC, which is 95% owned by the JHC Family 2016 Trust (the "JHC Trust"). The JHC Trust is an entity controlled by James H. Clark.

F4: Each share of Series C Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the IPO and has no expiration date.

F5: Each share of Series C-1 Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the IPO and has no expiration date.