SEC Form 4 · accession 0001209191-17-004314
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
Jan 13, 2017
Accepted (ET)
Jan 18, 2017 · 6:58 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 Stock | Jan 13, 2017 | M | 935,762 | $1.90 | A | 6,023,304 | D | |
| Common StockF1 | Jan 13, 2017 | F | 457,080 | $34.15 | D | 5,566,224 | D | |
| Common Stock | Jan 18, 2017 | M | 20 | $1.90 | A | 5,566,244 | D | |
| Common StockF1 | Jan 18, 2017 | F | 10 | $33.65 | D | 5,566,234 | 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 | $1.90 | Jan 13, 2017 | M | 935,762 | D | — | Jan 24, 2017 | Common Stock | 935,762 | 20 | D |
| Stock Option (right to buy)F3 | $1.90 | Jan 18, 2017 | M | 20 | D | — | Jan 24, 2017 | Common Stock | 20 | 0 | D |
Explanation of responses
- F1The reported shares were withheld to cover the Reporting Person's tax liability in connection with the exercise of stock options.
- 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.
- F3This option is fully vested and immediately exercisable.