SEC Form 4 · accession 0001513908-16-000064
ELLIE MAE INC · ELLI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sigmund Anderman
Officer — Founder & Executive Chairman · Director
Period of report
Sep 28, 2016
Accepted (ET)
Sep 30, 2016 · 5:08 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001122388
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Sep 28, 2016 | M | 19,920 | $5.02 | A | 177,794 | D | |
| Common StockF1 | holding | — | — | — | 71,953 | I | Sig GRAT 2014 | |
| Common StockF2 | holding | — | — | — | 71,953 | I | Susan GRAT 2014 | |
| Common Stock | holding | — | — | — | 10,000 | I | by 401(k) Plan | |
| Common Stock | holding | — | — | — | 93,431 | I | by Trust |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Incentive Stock Option (right to buy)F4,F3 | $5.02 | Sep 28, 2016 | M | 19,920 | D | — | Aug 17, 2021 | Common Stock | 19,920 | 0 | D |
Explanation of responses
- F1The shares are directly held by Sigmund Anderman TTEE Sigmund Anderman 2014 GRAT U/A DTD 12/12/2014.
- F2The shares are directly held by Susan Anderman TTEE Susan Anderman 2014 GRAT U/A DTD 12/12/2014.
- F3Option vests with respect to 25% of the shares subject thereto on August 17, 2012, with 1/48th of the shares vesting monthly thereafter, such that the option will be fully vested and exercisable on August 17, 2015.
- F4The reported transaction is a grant of a derivative security, in which we have left column 8 blank, and have reported the exercise or conversion price of the derivative security in column 2.