SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Sela Yossi

(Last) (First) (Middle)
C/O GEMINI ISRAEL VENTURES, 1 ABBA EBAN
AVE, MERKAZIM 2001, BLDG A, 3RD FLOOR

(Street)
HERZLIYA L3

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/15/2020
3. Issuer Name and Ticker or Trading Symbol
JFrog Ltd [ FROG ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Series A-1 Convertible Preferred Shares (1) (1) Ordinary Shares 10,727,945 (1) I See footnote(2)
Series A-1 Convertible Preferred Shares (1) (1) Ordinary Shares 108,363 (1) I See footnote(3)
Series B Convertible Preferred Shares (4) (4) Ordinary Shares 1,850,988 (4) I See footnote(2)
Series B Convertible Preferred Shares (4) (4) Ordinary Shares 18,697 (4) I See footnote(3)
Explanation of Responses:
1. The Series A-1 Convertible Preferred Shares shall automatically convert into Ordinary Shares on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering and have no expiration date.
2. The reported securities are shares held of record by shares held of record by Gemini Israel V Limited Partnership (Gemini V). Gemini Capital Associates V LP (Gemini Associates LP) is the general partner of Gemini V and Gemini Capital Associates V GP, Ltd. (Gemini Associates GP) is the general partner of Gemini Associates LP. The reporting person is a managing partner of Gemini Associates GP and disclaims beneficial ownership of the shares held of record Gemini Partners except to the extent of his pecuniary interest therein.
3. The reported securities are shares held of record by Gemini Partners Investors V L.P. (Gemini Partners). Gemini Israel Funds IV Ltd. (Gemini Israel) is the general partner of Gemini Partners. The reporting person is a managing partner of Gemini Israel and disclaims beneficial ownership of the shares held of record Gemini Partners except to the extent of his pecuniary interest therein.
4. The Series B Convertible Preferred Shares shall automatically convert into Ordinary Shares on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering and have no expiration date.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Eyal Ben David, by power of attorney 09/15/2020
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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