SEC Form 4 · accession 0000899243-18-026974
Anaplan, Inc. · PLAN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Shasta Ventures II GP, LLC
10% Owner
Period of report
Oct 16, 2018
Accepted (ET)
Oct 18, 2018 · 5:10 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001540755
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F3,F2 | Oct 16, 2018 | C | 13,281,794 | — | A | 13,427,098 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A Convertible Preferred StockF3,F2 | — | Oct 16, 2018 | C | 37,569 | D | — | — | Common Stock | 37,569 | 0 | D |
| Series B Convertible Preferred StockF3,F2 | — | Oct 16, 2018 | C | 8,876,265 | D | — | — | Common Stock | 8,876,265 | 0 | D |
| Series C Convertible Preferred StockF3,F2 | — | Oct 16, 2018 | C | 3,136,369 | D | — | — | Common Stock | 3,136,369 | 0 | D |
| Series D Convertible Preferred StockF3,F2 | — | Oct 16, 2018 | C | 984,044 | D | — | — | Common Stock | 984,044 | 0 | D |
| Series E Convertible Preferred StockF3,F2 | — | Oct 16, 2018 | C | 247,547 | D | — | — | Common Stock | 247,547 | 0 | D |
Explanation of responses
- F1The total represents shares received upon conversion of shares of Series A Convertible Preferred Stock, Series B Convertible Preferred Stock, Series C Convertible Preferred Stock, Series D Convertible Preferred Stock and Series E Convertible Preferred Stock.
- F2Shasta Ventures II GP, LLC is the general partner of Shasta Ventures II, L.P. Ravi Mohan, a member of the issuer's Board of Directors, Robert Coneybeer, Tod Francis, and Jason Pressman are the managing members of Shasta Ventures II GP, LLC and each of them may be deemed to exercise voting and investment power over the shares held of record by Shasta Ventures II, L.P. These individuals disclaim beneficial ownership of the shares held by the aforementioned entities except to the extent of any pecuniary interest therein.
- F3The reported security converted into the Issuer's Common Stock on a 1-for-1 basis automatically immediately prior to the closing of the Issuer's initial public offering without payment of further consideration. The shares have no expiration date.