SEC Form 5 · accession 0000899243-18-003298
QUALYS, INC. · QLYS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Philippe F Courtot
Officer — Chairman, President & CEO · Director · 10% Owner
Period of report
Dec 31, 2017
Accepted (ET)
Feb 8, 2018 · 6:19 pm EST
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 StockF1 | Nov 30, 2017 | G | 34,000 | $0.00 | D | 5,478,934 | D | |
| Common StockF2 | holding | — | — | — | 100,000 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F3 | $3.80 | holding | — | — | — | — | Dec 2, 2019 | Common Stock | 231,927 | 231,927 | D |
| Stock Option (right to buy)F3 | $26.86 | holding | — | — | — | — | Feb 6, 2024 | Common Stock | 398,000 | 398,000 | D |
| Stock Option (right to buy)F4 | $25.56 | holding | — | — | — | — | Apr 28, 2026 | Common Stock | 500,000 | 500,000 | D |
Explanation of responses
- F1The reported shares reflect the current ownership of the Reporting Person and incorporates the gift reporting as referenced on Table I of this Form 5.
- F2These shares are held directly by a custodian under the Uniform Gifts to Minors Act for the benefit of the Reporting Person's minor child.
- F3The option is fully vested and immediately exercisable.
- F4Shares subject to the option vest in forty-eight equal monthly installments beginning on April 28, 2016.