SEC Form 4 · accession 0001667731-16-000093
MODEL N, INC. · MODN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Christopher Larsen
Officer — SVP and Chief Customer Officer
Period of report
Nov 15, 2016
Accepted (ET)
Nov 17, 2016 · 6:17 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001118417
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Nov 15, 2016 | M | 26,539 | $0.00 | A | 160,995 | D | |
| Common Stock | Nov 16, 2016 | S | 8,523 | $8.53 | D | 152,472 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitsF3,F4 | — | Nov 15, 2016 | M | 26,539 | D | — | — | Common Stock | 26,539 | 26,539 | D |
Explanation of responses
- F1Vesting of restricted stock units ("RSUs") granted to the Reporting Person on November 25, 2013.
- F2All of the shares reported as disposed of in this Form 4 were sold by the Reporting Person in order to pay the federal and state tax withholding obligations resulting for the vesting of the Reporting Person's RSUs. The Reporting Person did not sell or otherwise dispose of any shares reported in this Form 4 for any reason other than to cover required taxes.
- F3Each RSU represents a contingent right to receive one share of the Issuer's common stock.
- F425% of the RSUs granted to the Reporting Person on November 25, 2013 vest on each of November 15, 2014, November 15, 2015, November 15, 2016 and November 15, 2017, subject to the Reporting Person's continuing service with the company through the applicable vesting dates.
Remarks
SVP and Chief Customer Officer