SEC Form 4 · accession 0001209191-15-087374

MINDBODY, Inc. · MB

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

Reporting owner

Officer — President & CEO · Director · 10% Owner

Period of report

Dec 28, 2015

Accepted (ET)

Dec 30, 2015 · 4:05 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001458962

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Class A Common Stock	Dec 28, 2015	C	10,667	$0.00	A	27,921	D
Class A Common Stock	Dec 28, 2015	G	10,667	$0.00	D	17,254	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Class B Common Stock^F2	—	Dec 28, 2015	C	10,667	D	—	—	Class A Common Stock	10,667	1,173,990	D
Class B Common Stock^F3,F2	—	holding	—	—	—	—	—	Class A Common Stock	23,750	23,750	I
Class B Common Stock^F4,F2	—	holding	—	—	—	—	—	Class A Common Stock	1,250	1,250	I
Class B Common Stock^F5,F2	—	holding	—	—	—	—	—	Class A Common Stock	1,250	1,250	I

F1Each share of Class A Common Stock was issued upon the conversion of one share of Class B Common Stock at the election of Reporting Person.
F2Each share of Class B Common Stock is convertible into one share of Class A Common Stock at the option of the holder and has no expiration date.
F3The shares are held of record by the Reporting Person's spouse.
F4The shares are held of record by the Reporting Person as custodian for the benefit of his minor child.
F5The shares are held of record by the Reporting Person's spouse as custodian for the benefit of her minor child.