SEC FORM 3 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*
Laughton Mary Beth

(Last) (First) (Middle)
C/O MAPLEBEAR INC.
50 BEALE STREET, SUITE 600

(Street)
SAN FRANCISCO CA 94105

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/16/2024
3. Issuer Name and Ticker or Trading Symbol
Maplebear Inc. [ CART ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
checkbox checked 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)
checkbox checked 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
Explanation of Responses:
No securities are beneficially owned.
/s/ Bradley Libuit, Attorney-in-Fact 08/19/2024
** 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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POWER OF ATTORNEY

Know all by these presents, that the undersigned hereby constitutes and
appoints Morgan Fong, Bradley Libuit, and Kelsey Wilcox of Maplebear Inc.
and Milson Yu and Eric Steiner of Cooley LLP, or any of them signing
singly, with full power of substitution, the undersigned's true and
lawful attorney in fact to:
(1)        prepare, execute in the undersigned's name and on the
undersigned's behalf, and submit to the U.S. Securities and
Exchange Commission (the ?SEC?) a Form ID Application to Obtain
EDGAR Access Codes, if applicable, and any other forms necessary
to generate EDGAR codes on my behalf enabling the undersigned to
make electronic filings with the SEC of reports required by
Section 16(a) of the Securities Exchange Act of 1934 or any rule
or regulation of the SEC;
(2)        execute for and on behalf of the undersigned, in
the undersigned's capacity as a director, officer and/or
a 10% stockholder of Maplebear Inc. (the ?Company?), Forms
3, 4, and 5 in accordance with Section 16(a) of the Securities
Exchange Act of 1934 and the rules thereunder;
(3)        do and perform any and all acts for and on behalf
of the undersigned which may be necessary or desirable to
complete and execute any such Form 3, 4, or 5, complete and
execute any amendment or amendments thereto, and timely file
such form with the SEC and any stock exchange or similar authority;
and
(4)        take any other action of any type whatsoever in
connection with the foregoing which, in the opinion of such attorney
in fact, may be of benefit to, in the best interest of, or legally
required by, the undersigned, it being understood that the documents
executed by such attorney in fact on behalf of the undersigned pursuant
to this Power of Attorney shall be in such form and shall contain such
terms and conditions as such attorney in fact may approve in such
attorney in fact?s discretion.
The undersigned hereby grants to such attorney in fact full power
and authority to do and perform any and every act and thing whatsoever
requisite, necessary, or proper to be done in the exercise of any of
the rights and powers herein granted, as fully to all intents and
purposes as the undersigned might or coulddo if personally present,
with full power of substitution or revocation, hereby ratifying and
confirming all that such attorney in fact, or such attorney in fact?s
substitute or substitutes, shall lawfully do or cause to be done by
virtue of this power of attorney and the rights and powers herein
granted.
This Power of Attorney shall remain in full force and effect until
either the undersigned is no longer required to file Forms 3, 4, and 5
with respect to the undersigned's holdings of and transactions in
securities issued by the Company or unless earlier revoked by the
undersigned in a signed writing delivered to
the foregoing attorney in fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney
to be executed as of this 19th day of August, 2024.

/s/ Mary Beth Laughton