SEC Form 4 · accession 0001140361-17-015608
HEALTHEQUITY, INC. · HQY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Stephen Neeleman
Officer — Founder and Vice Chairman · Director
Period of report
Apr 7, 2017
Accepted (ET)
Apr 11, 2017 · 8:32 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001428336
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Apr 7, 2017 | G | 10,000 | $0.00 | D | 835,285 | I | See footnote |
| Common Stock | holding | — | — | — | 0 | D | ||
| Common StockF2 | holding | — | — | — | 291,613 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F3 | $41.28 | holding | — | — | — | — | Mar 27, 2027 | Common Stock | 19,897 | 19,897 | D |
| Stock Option (right to buy)F4 | $14.00 | holding | — | — | — | — | Jul 30, 2024 | Common Stock | 46,000 | 46,000 | D |
| Stock Option (right to buy)F4 | $1.25 | holding | — | — | — | — | Aug 8, 2021 | Common Stock | 654 | 654 | D |
Explanation of responses
- F1Shares held of record by the Stephen and Christine Neeleman Trust.
- F2Shares held of record by Neeleman Family Holdings, LLC ("Family Holdings"), a Utah limited liability company. The reporting person is the manager of Family Holdings. The reporting person disclaims beneficial ownership of the shares held by Family Holdings except to the extent of his pecuniary interest therein and this report shall not be deemed an admission that the reporting person is the beneficial owner of the shares held by Family Holdings for any other purposes.
- F3The option becomes exercisable in three annual installments of 4,974 shares on March 27, 2018, 2019, and 2020 and in one installment of 4,975 shares on March 27, 2021.
- F4The option is immediately exercisable.
Remarks
The Power of Attorney given by Mr. Neeleman was previously filed with the U.S. Securities & Exchange Commission on March 3, 2017 as an exhibit to a statement on Form 4 filed by Mr. Neeleman with respect to HealthEquity, Inc. and is hereby incorporated by reference.