Ownership Submission
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FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549INITIAL 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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OMB APPROVAL
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OMB Number:3235-0104Expires:January 31, 2005Estimated average burden hours per response...0.5
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1. Name and Address of Reporting Person *
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Galvin Carmel
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2. Date of Event Requiring Statement (Month/Day/Year)
2024-09-25
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3. Issuer Name and Ticker or Trading Symbol
Klaviyo, Inc. [KVYO]
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(Last)
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(First)
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(Middle)
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C/O KLAVIYO, INC. , 125 SUMMER STREET, 6TH FLOOR
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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_____ Director
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_____ 10% Owner
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_____ Officer (give title below)
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_____ Other (specify below)
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Chief People Officer /
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5. If Amendment, Date Original Filed(Month/Day/Year)
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6. Individual or Join/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
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2. Amount of Securities Beneficially Owned
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3. Ownership Form: Direct (D) or Indirect (I)
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4. Nature of Indirect Beneficial Ownership
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
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2. Date Exercisable and Expiration Date
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3. Title and Amount of Securities Underlying Derivative Security
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
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6. Nature of Indirect Beneficial Ownership
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Date Exercisable
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Expriation Date
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Title
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Amount or Number of Shares
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Galvin Carmel
C/O KLAVIYO, INC.
125 SUMMER STREET, 6TH FLOOR
BOSTON, MA02110
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Chief People Officer
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Signatures
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/s/ Landon Edmond, Attorney-in-Fact
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2024-10-04
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**Signature of Reporting Person
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Date
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Explanation of Responses:
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(*)
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If the form is filed by more than one reporting person, see Instruction 5(b)(v).
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(**)
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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(1)
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Consists of 691,144 unvested restricted stock units ("RSUs") awarded under the Issuer's 2023 Stock Option and Incentive Plan, each representing the contingent right to receive one share of the Issuer's Series A Common Stock, par value $0.001 per share, upon vesting and settlement. The RSUs vest as follows: 86,393 RSUs will vest on November 15, 2024, with the remaining RSUs vesting in fourteen equal quarterly installments thereafter, subject to the Reporting Person's continued service to the Issuer on each such vesting date.
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Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
See Instruction 6 for procedure.Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
