SEC Form 4 · accession 0000899243-18-017233
AVALARA, INC. · AVLR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Gary Waterman
Director
Period of report
Jan 24, 2018
Accepted (ET)
Jun 19, 2018 · 6:43 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001348036
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | May 8, 2018 | M | 10,000 | $4.50 | A | 67,500 | D | |
| Common StockF1 | May 8, 2018 | M | 10,000 | $9.72 | A | 77,500 | D | |
| Common StockF1 | May 8, 2018 | M | 10,000 | $12.20 | A | 87,500 | D | |
| Common StockF1 | May 8, 2018 | M | 10,000 | $12.60 | A | 97,500 | D | |
| Common StockF1 | May 8, 2018 | M | 10,000 | $13.84 | A | 107,500 | D | |
| Common StockF1 | May 8, 2018 | M | 10,000 | $16.60 | A | 117,500 | D | |
| Common StockF2 | Jun 19, 2018 | C | 801,449 | — | A | 918,919 | D | |
| Common StockF2 | Jun 19, 2018 | C | 226,928 | — | A | 1,145,877 | D | |
| Common StockF2 | Jun 19, 2018 | C | 131,383 | — | A | 1,277,260 | D | |
| Common StockF2 | Jun 19, 2018 | C | 45,454 | — | A | 1,322,714 | D | |
| Common StockF2 | Jun 19, 2018 | C | 39,556 | — | A | 1,362,270 | D | |
| Common StockF2 | Jun 19, 2018 | C | 74,074 | — | A | 1,436,344 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant (right to buy)F3,F4 | $16.60 | Jan 24, 2018 | A | 10,000 | A | — | — | Common Stock | 10,000 | 10,000 | D |
| Warrant (right to buy)F3,F4 | $16.60 | May 8, 2018 | M | 10,000 | D | — | — | Common Stock | 10,000 | 0 | D |
| Warrant (right to buy)F3,F4 | $13.84 | May 8, 2018 | M | 10,000 | D | — | — | Common Stock | 10,000 | 0 | D |
| Warrant (right to buy)F3,F4 | $12.60 | May 8, 2018 | M | 10,000 | D | — | — | Common Stock | 10,000 | 0 | D |
| Warrant (right to buy)F3,F4 | $12.20 | May 8, 2018 | M | 10,000 | D | — | — | Common Stock | 10,000 | 0 | D |
| Warrant (right to buy)F3,F4 | $9.72 | May 8, 2018 | M | 10,000 | D | — | — | Common Stock | 10,000 | 0 | D |
| Warrant (right to buy)F3,F4 | $4.50 | May 8, 2018 | M | 10,000 | D | — | — | Common Stock | 10,000 | 0 | D |
| Series A Preferred StockF2 | — | Jun 19, 2018 | C | 1,602,903 | D | — | — | Common Stock | 801,449 | 0 | D |
| Series A-1 Preferred StockF2 | — | Jun 19, 2018 | C | 453,856 | D | — | — | Common Stock | 226,928 | 0 | D |
| Series B Preferred StockF2 | — | Jun 19, 2018 | C | 262,767 | D | — | — | Common Stock | 131,383 | 0 | D |
| Series B-1 Preferred StockF2 | — | Jun 19, 2018 | C | 90,909 | D | — | — | Common Stock | 45,454 | 0 | D |
| Series D-1 Preferred StockF2 | — | Jun 19, 2018 | C | 79,113 | D | — | — | Common Stock | 39,556 | 0 | D |
| Series D-2 Preferred StockF2 | — | Jun 19, 2018 | C | 148,148 | D | — | — | Common Stock | 74,074 | 0 | D |
Explanation of responses
- F1The shares issuable upon exercise of the warrant are subject to the terms of a lock-up agreement entered into in connection with the Issuer's initial public offering.
- F2Shares of preferred stock automatically converted into shares of common stock on a 2-to-1 basis immediately prior to the closing of the Issuer's initial public offering with cash paid in lieu of a fractional share. The preferred stock had no expiration date.
- F3The warrant was fully exercisable upon grant.
- F4Unless sooner exercised, the warrant expires immediately prior to the closing of the Issuer's initial public offering and will be automatically net exercised pursuant to its terms if not exercised prior to that time.