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*
Sturdy Laela

(Last) (First) (Middle)
C/O UIPATH, INC., 90 PARK AVE, 20TH FL

(Street)
NEW YORK NY 10016

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
04/20/2021
3. Issuer Name and Ticker or Trading Symbol
UiPath, Inc. [ PATH ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 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)
Class A Common Stock 16,057(1) D
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 B-1 Preferred Stock (2) (2) Class A Common Stock 10,004,580 (2) I By CapitalG LP(3)
Series B-2 Preferred Stock (2) (2) Class A Common Stock 2,967,450 (2) I By CapitalG LP(3)
Series C-1 Preferred Stock (2) (2) Class A Common Stock 2,178,705 (2) I By CapitalG LP(3)
Series C-1 Preferred Stock (2) (2) Class A Common Stock 6,536,115 (2) I By CapitalG II LP(4)
Series C-2 Preferred Stock (2) (2) Class A Common Stock 1,740,180 (2) I By CapitalG LP(3)
Series C-2 Preferred Stock (2) (2) Class A Common Stock 5,220,537 (2) I By CapitalG II LP(4)
Series D-1 Preferred Stock (2) (2) Class A Common Stock 1,631,871 (2) I By CapitalG II LP(4)
Series D-2 Preferred Stock (2) (2) Class A Common Stock 274,020 (2) I By CapitalG II LP(4)
Explanation of Responses:
1. Consists of 16,057 Restricted Stock Units (RSUs). Each RSU represents a contingent right to receive one share of the Issuer's Class A Common Stock upon settlement. Following the closing of the Issuer's initial public offering (IPO), 1/16th of the RSUs vest for each quarter of continuous service by the Reporting Person to the Issuer following March 16, 2021 and subject to continuous service through each such vesting date, and in each case subject to a performance based vesting condition satisfied upon the closing of the Issuer's IPO.
2. Each share of Series B-1 Preferred Stock, Series B-2 Preferred Stock, Series C-1 Preferred Stock, Series C-2 Preferred Stock, Series D-1 Preferred Stock and Series D-2 Preferred Stock will automatically convert into one share of Class A Common Stock immediately prior to the closing of the Issuer's IPO, and has no expiration date.
3. CapitalG GP LLC, is the general partner of CapitalG LP. Alphabet Holdings LLC, the managing member of CapitalG GP LLC, XXVI Holdings Inc., the managing member of Alphabet Holdings LLC, and Alphabet Inc., the controlling stockholder of XXVI Holdings Inc., each may be deemed to share voting and investment power over the shares held by CapitalG LP. The Reporting Person is a general partner of CapitalG LP and may be deemed to share voting and investment power over the shares. The Reporting Person disclaims beneficial ownership of the shares held by CapitalG LP except to the extent of her pecuniary interest in such shares.
4. CapitalG II GP LLC, is the general partner of CapitalG II LP. Alphabet Holdings LLC, the managing member of CapitalG II GP LLC, XXVI Holdings Inc., the managing member of Alphabet Holdings LLC, and Alphabet Inc., the controlling stockholder of XXVI Holdings Inc., each may be deemed to share voting and investment power over the shares held by CapitalG II LP. The Reporting Person is a general partner of CapitalG II LP and may be deemed to share voting and investment power over the shares. The Reporting Person disclaims beneficial ownership of the shares held by CapitalG II LP except to the extent of her pecuniary interest in such shares.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Brad Brubaker, Attorney-in-Fact 04/20/2021
** 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.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.