SEC Form 4
FORM 4 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
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Hartz Julia

(Last) (First) (Middle)
C/O EVENTBRITE, INC.
155 5TH STREET, 7TH FLOOR

(Street)
SAN FRANCISCO CA 94103

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Eventbrite, Inc. [ EB ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chief Executive Officer
3. Date of Earliest Transaction (Month/Day/Year)
11/11/2019
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 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
Class A Common Stock 11/11/2019 A(1) 614 A $0.00 614 I See Footnote(2)
Class A Common Stock 418,490 I See Footnote(3)
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 (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 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 (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (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: 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
Class B Common Stock (4) (4) (4) Class A Common Stock 4,273,601 4,273,601 I See Footnote(2)
Class B Common Stock (4) (4) (4) Class A Common Stock 411,026 411,026 I See Footnote(3)
Class B Common Stock (4) (4) (4) Class A Common Stock 2,627,266 2,627,266 I See Footnote(5)
Class B Common Stock (4) (4) (4) Class A Common Stock 1,000,000 1,000,000 D
Explanation of Responses:
1. Receipt of shares as part of a pro rata distribution-in-kind to the members of an investment fund.
2. The shares are owned by the Kevin Earnest Hartz & Julia D. Hartz, Trustees of the Hartz Family Revocable Trust dated 12/4/08 of which the Reporting Person is a co-trustee.
3. The shares are held by Kevin Hartz, who is the Chairman of the Issuer's Board of Directors and the spouse of the Reporting Person, and as such the shares may be deemed to be beneficially held by the Reporting Person.
4. Each share of Class B common stock is convertible into one share of Class A common stock at the option of the holder and has no expiration date.
5. The shares are owned by the Hartz 2008 Irrevocable Trust dated 9/15/08 of which the Reporting Person is a co-trustee.
Remarks:
/s/ Samantha Harnett, Attorney-in-fact of the Reporting Person 11/15/2019
** 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 4 (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.