SEC Form 4 · accession 0001667731-17-000201
MODEL N, INC. · MODN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Zack Rinat
Officer — CEO and Executive Chairman · Director · 10% Owner
Period of report
Sep 8, 2017
Accepted (ET)
Sep 12, 2017 · 4:59 pm EDT
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 StockF1 | Sep 8, 2017 | A | 169,331 | $0.00 | A | 2,487,869 | D | |
| Common Stock | holding | — | — | — | 26,907 | I | By GADD, Inc. | |
| Common Stock | holding | — | — | — | 666,666 | I | By the Danielle Rinat Family Heritage Trust dated December 12, 2005 | |
| Common Stock | holding | — | — | — | 666,666 | I | By the Gahl Rinat Family Heritage Trust Dated December 12, 2005 | |
| Common Stock | holding | — | — | — | 36,310 | I | By the Gahl Rinat Trust | |
| Common Stock | holding | — | — | — | 36,311 | I | By the Danielle Rinat Trust | |
| Common Stock | holding | — | — | — | 1,666,666 | I | By the Rinat Family 2006 Trust Dated December 13, 2006 |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Issuable upon the vesting and satisfaction of certain performance criteria of Performance-Based Restricted Stock Units ("PB-RSUs"). Subject to the achievement of certain minimum performance criteria based upon total stockholder return, between a minimum of 0% and a maximum of 250%, the PB-RSUs will vest as to 50% on each of the second and third annual anniversary of the vesting commencement date until such time as the PB-RSUs are 100% vested, subject to the continuing employment of the Reporting Person on each vesting date. Shares of the Issuer's common stock will be delivered to the Reporting Person upon vesting if the performance criteria have been met.