SEC Form 4 · accession 0000899243-16-019283
QUALYS, INC. · QLYS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Donald R Dixon
Director
Period of report
May 4, 2016
Accepted (ET)
May 5, 2016 · 4:05 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001107843
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF2,F3 | May 4, 2016 | J | 1,409,826 | $0.00 | D | 0 | I | See footnote |
| Common StockF3,F4 | May 4, 2016 | J | 107,106 | $0.00 | D | 0 | I | See footnote |
| Common StockF3,F5 | May 4, 2016 | J | 39,214 | $0.00 | D | 0 | I | See footnote |
| Common StockF3,F6 | May 4, 2016 | J | 8,191 | $0.00 | D | 0 | I | See footnote |
| Common StockF3,F7 | May 4, 2016 | J | 7,818 | $0.00 | D | 0 | I | See footnote |
| Common Stock | May 4, 2016 | J | 49,213 | $0.00 | A | 193,391 | D | |
| Common StockF10 | May 4, 2016 | J | 42,242 | $0.00 | A | 165,074 | I | See footnote |
| Common StockF12 | May 4, 2016 | J | 320 | $0.00 | A | 1,283 | I | See footnote |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Represents an in-kind distribution to the partners of the applicable partnership in accordance with the partners' relative economic interests in such partnership and includes subsequent distributions by general partners or managing members to their respective partners or members.
- F10The shares are held directly by Donald and Elizabeth Dixon Family Limited Partnership, for which the Reporting Person and his spouse serve as general partners.
- F11Represents the receipt of shares by virtue of the distribution described in footnote (6) above. The acquisition of such shares was exempt under Rule 16a-9 and Rule 16a-13.
- F12The shares are held directly by Dixon Family Trust U/A Dated 6/18/88, for which the Reporting Person and his spouse serve as settlors.
- F2The shares are held directly by Trident Capital Fund-V, L.P.
- F3Trident Capital Management-V, L.L.C. ("TCMV") serves as the general partner of each of Trident Capital Fund-V, L.P., Trident Capital Fund-V Principals Fund, L.P., Trident Capital Fund-V Affiliates Fund, L.P., and Trident Capital Fund-V Affiliates Fund (Q), L.P., and as the sole investment general partner of Trident Capital Parallel Fund-V, C.V. As such, TCMV may be deemed to be the beneficial owner of the shares held directly by each of these Trident entities. Additionally, Donald R. Dixon, as a member of TCMV, may be deemed to share beneficial ownership in securities beneficially owned by TCMV. TCMV and Mr. Dixon each disclaim beneficial ownership of these securities except to the extent of their respective pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purpose.
- F4The shares are held directly by Trident Capital Parallel Fund-V, C.V.
- F5The shares are held directly by Trident Capital Fund-V Principals Fund, L.P.
- F6The shares are held directly by Trident Capital Fund-V Affiliates Fund, L.P.
- F7The shares are held directly by Trident Capital Fund-V Affiliates Fund (Q), L.P.
- F8Represents the receipt of shares by virtue of the distributions described in footnotes (2), (4) and (5) above as follows: (i) 34,905 shares from Trident Capital Fund-V, L.P., (ii) 2,646 shares from Trident Capital Parallel Fund-V, C.V., and (iii) 11,662 shares from Trident Capital Fund-V Principals Fund, L.P. The acquisition of such shares was exempt under Rule 16a-9 and Rule 16a-13.
- F9Represents the receipt of shares by virtue of the distributions described in footnotes (2) and (4) above as follows: 39,266 shares from Trident Capital Fund-V, L.P., and (ii) 2,976 shares from Trident Capital Parallel Fund-V, C.V. The acquisition of such shares was exempt under Rule 16a-9 and Rule 16a-13.