SEC Form 4 · accession 0001209191-16-142323

EVERBRIDGE, INC. · EVBG

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Director

Period of report

Sep 21, 2016

Accepted (ET)

Sep 21, 2016 · 6:11 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001437352

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1,F2	Sep 21, 2016	C	171,974	—	A	1,131,628	I	See Footnote
Common Stock^F3,F2	Sep 21, 2016	S	190,211	$11.16	D	941,417	I	See Footnote
Common Stock	holding	—	—		—	23,179	D
Common Stock^F4	holding	—	—		—	521,739	I	See Footnote
Common Stock^F5	holding	—	—		—	521,739	I	See Footnote
Common Stock	holding	—	—		—	1,304	I	By spouse

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Series A-1 Preferred Stock^F1,F2	—	Sep 21, 2016	C	171,974	D	—	—	Common Stock	171,974	0	I

F1The Series A-1 Preferred Stock, which had no expiration date, automatically converted to common stock on a 1-for-1 basis upon the completion of the Issuer's initial public offering.
F2The shares are held by the Steven T. Kirchmeier and Cintawati W. Putra Living Trust Dated May 5, 2015, of which the reporting person and her spouse are trustee.
F3The shares were sold in the Issuer's initial public offering, pursuant to a Form S-1 Registration Statement which was declared effective on September 15, 2016. The reported sale price reflects the price at which the shares were sold to the underwriters.
F4The shares are held by the Cintawati W. Putra 2015 Grantor Retained Annuity Trust, of which the reporting person and her spouse are trustee.
F5The shares are held by the Steven T. Kirchmeier 2015 Grantor Retained Annuity Trust, of which the reporting person and her spouse are trustee.