SEC Form 4 · accession 0001209191-16-107774
Five9, Inc. · FIVN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owners
Ann L Winblad
10% Owner
HUMMER WINBLAD VENTURE PARTNERS V LP
10% Owner
John Hummer
10% Owner
Period of report
Mar 10, 2016
Accepted (ET)
Mar 11, 2016 · 3:11 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001288847
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF3 | Mar 10, 2016 | J | 400,000 | $0.00 | D | 8,010,041 | I | See Footnote |
| Common StockF1 | holding | — | — | — | 52,173 | I | See Footnote |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The reported shares are held directly by Mitchell Kertzman, who is a managing member of Hummer Winblad Equity Partners V, L.L.C. ("HWEP V"), which is the general partner of Hummer Winblad Venture Partners V, L.P. ("HWVP V") and Hummer Winblad Venture Partners V-A, L.P. ("HWVP VA"). By agreement with HWEP V, Mr. Kertzman holds the shares for the benefit of HWEP V. Mr. Kertzman disclaims beneficial ownership of the shares except to the extent of his pecuniary interest therein.
- F2HWVP V distributed for no consideration an aggregate of 400,000 shares of Common Stock of the Issuer to its limited partners on a pro rata basis.
- F3The reported shares are held directly by HWVP V as nominee for HWVP V and HWVP VA. John Hummer, Ann Winblad and Mitchell Kertzman are the managing members of HWEP V, which is the general partner of HWVP V and HWVP VA. HWEP V, Mr. Hummer, Ms. Winblad and Mr. Kertzman disclaim beneficial ownership of all securities held by HWVP V, except to the extent of their pecuniary interests therein.
Remarks
This Form 4 is one of two Form 4s filed on the date hereof reporting this transaction. The Reporting Person for the other Form 4 is Mitchell Kertzman.