SEC Form 4 · accession 0001209191-17-062174
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
Nov 17, 2017
Accepted (ET)
Nov 21, 2017 · 6:36 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001419625
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common StockF1,F2 | Nov 17, 2017 | C | 1,150,000 | $0.00 | A | 1,150,000 | I | See footnote |
| Class A Common StockF2 | Nov 17, 2017 | J | 1,150,000 | $0.00 | D | 0 | I | See footnote |
| Class A Common StockF5 | Nov 17, 2017 | J | 3,461 | $0.00 | A | 12,146 | D | |
| Class A Common StockF6 | Nov 17, 2017 | J | 1,066 | $0.00 | A | 1,066 | I | See footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Class B Common StockF1,F8,F2,F7 | $0.00 | Nov 17, 2017 | C | 1,150,000 | D | — | — | Class A Common Stock | 1,150,000 | 4,049,786 | I |
Explanation of responses
- F1Includes 1,105,824 shares held by Madrona Venture Fund III, L.P. ("Madrona III") and 44,176 shares held by Madrona Venture Fund III-A, L.P. ("Madrona III-A").
- F2Shares are held by Madrona III and Madrona III-A. Mr. McIlwain 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. The reporting person disclaims beneficial ownership of the shares except to the extent of his pecuniary interest therein.
- F3Represents a pro rata distribution for no consideration to the limited partners and general partners of Madrona III and Madrona III-A (the "Distribution").
- F4Acquisition by the reporting person, who is a Managing Director of the various entities affiliated with Madrona, pursuant to the Distribution.
- F5Includes 8,685 RSUs that represent contingent rights to receive 8,685 shares of the Issuer's Class A Common Stock upon settlement.
- F6Acquisition by the McIlwain Family GST Trust, pursuant to the Distribution.
- 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.
- F8Includes 3,894,216 shares held by Madrona III and 155,570 shares held Madrona III-A.