SEC Form 4 · accession 0000899243-16-030232
Apptio Inc · APTI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Matthew S McIlwain
Director · 10% Owner
Period of report
Sep 28, 2016
Accepted (ET)
Sep 28, 2016 · 4:30 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001419625
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A Preferred StockF1,F6 | — | Sep 28, 2016 | C | 2,295,000 | D | — | — | Class B Common Stock | 2,295,000 | 0 | I |
| Series B Preferred StockF2,F6 | — | Sep 28, 2016 | C | 1,509,095 | D | — | — | Class B Common Stock | 1,509,095 | 0 | I |
| Series C Preferred StockF3,F6 | — | Sep 28, 2016 | C | 763,076 | D | — | — | Class B Common Stock | 763,076 | 0 | I |
| Series D Preferred StockF4,F6 | — | Sep 28, 2016 | C | 430,806 | D | — | — | Class B Common Stock | 430,806 | 0 | I |
| Series E Preferred StockF5,F6 | — | Sep 28, 2016 | C | 201,809 | D | — | — | Class B Common Stock | 201,809 | 0 | I |
| Class B Common StockF1,F2,F3,F4,F5,F7 | — | Sep 28, 2016 | C | 5,199,786 | A | — | — | Class A Common Stock | 5,199,786 | 5,199,786 | I |
Explanation of responses
- F1Includes 2,206,839 shares held by Madrona Venture Fund III, L.P.("Madrona III") and 88,161 shares held by Madrona Venture Fund III-A, L.P. ("Madrona III-A"). Matthew McIlwain (who is a director of the issuer and files separate section 16(a) reports) is a managing director of the various entities affiliated with Madrona. Madrona Investment Partners III, L.P. is the general partner of Madrona III and Madrona III-A. Mr. McIlwain disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
- F2Includes 1,451,124 shares held by Madrona III and 57,971 shares held by Madrona III-A. Mr. McIlwain disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
- F3Includes 733,763 shares held by Madrona III and 29,313 shares held by Madrona III-A. Mr. McIlwain disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
- F4Includes 414,257 shares held by Madrona III and 16,549 shares held by Madrona III-A. Mr. McIlwain disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
- F5Includes 194,057 shares held by Madrona III and 7,752 shares held by Madrona III-A. Mr. McIlwain disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
- F6The Preferred Stock converted into Class B Common Stock on a 1-for-1 basis immediately prior to the closing of the issuer's initial public offering and had no expiration date.
- F7Class B Common Stock is convertible at any time, at the holder's election, into Class A Common Stock on a 1-for-1 basis and has no expiration date.