SEC Form 4 · accession 0001209191-18-029660
Apptio Inc · APTI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Ravi Mohan
Director
Period of report
May 9, 2018
Accepted (ET)
May 11, 2018 · 6:15 pm EDT
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 | May 9, 2018 | C | 890,917 | $0.00 | A | 890,917 | I | See footnote |
| Class A Common StockF1 | May 9, 2018 | J | 890,917 | $0.00 | D | 0 | I | See footnote |
| Class A Common StockF4 | May 9, 2018 | J | 4,961 | $0.00 | A | 19,238 | D |
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,F5 | $0.00 | May 9, 2018 | C | 890,917 | D | — | — | Class A Common Stock | 890,917 | 0 | I |
Explanation of responses
- F1These shares are held by Shasta Ventures, L.P. Shasta Ventures GP, LLC is the general partner of Shasta Ventures, L.P. Mr. Mohan is a managing member of Shasta Ventures GP, LLC. Mr. Mohan disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein.
- F2Represents a pro rata distribution for no consideration to the limited partners of Shasta Ventures, L.P. (the "Distribution").
- F3Acquisition by the reporting person, who is a limited partner of Shasta Ventures, L.P., pursuant to the Distribution.
- F4Includes 8,685 RSUs that represent contingent rights to receive 8,685 shares of the Issuer's Class A Common Stock upon settlement.
- F5Class 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.