SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
JVP CORP IV

(Last) (First) (Middle)
C/O JERUSALEM VENTURE PARTNERS
HEBRON ROAD 24

(Street)
JERUSALEM L3 93542

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/15/2010
3. Issuer Name and Ticker or Trading Symbol
QLIK TECHNOLOGIES INC [ QLIK ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 349,057 I By: Jerusalem Venture Partners IV, L.P.(1)
Common Stock 241,253 I By: JVP IV Annex Fund, L.P.(2)
Common Stock 22,273 I By: JVP IV Annex Entrepreneur Fund, L.P.(3)
Common Stock 8,396 I By: Jerusalem Venture Partners IV (Israel), L.P.(4)
Common Stock 3,127 I By: Jerusalem Venture Partners Entrepreneurs Fund IV, L.P.(5)
Common Stock 2,945 I By: Jerusalem Venture Partners IV-A, L.P.(6)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Series A Preferred Stock (7) (8) Common Stock 9,181,178 (9) I By: Jerusalem Venture Partners IV, L.P.(1)
Series A Preferred Stock (7) (8) Common Stock 220,899 (9) I By: Jerusalem Venture Partners IV (Israel), L.P.(4)
Series A Preferred Stock (7) (8) Common Stock 82,240 (9) I By: Jerusalem Venture Partners Entrepreneurs Fund IV, L.P.(5)
Series A Preferred Stock (7) (8) Common Stock 78,414 (9) I By: Jerusalem Venture Partners IV-A, L.P.(6)
Series AA Preferred Stock (7) (8) Common Stock 5,297,226 (9) I By: Jerusalem Venture Partners IV, L.P.(1)
Series AA Preferred Stock (7) (8) Common Stock 361,990 (9) I By: JVP IV Annex Fund, L.P.(2)
Series AA Preferred Stock (7) (8) Common Stock 33,420 (9) I By: JVP IV Annex Entrepreneur Fund, L.P.(3)
Series AA Preferred Stock (7) (8) Common Stock 127,451 (9) I By: Jerusalem Venture Partners IV (Israel), L.P.(4)
Series AA Preferred Stock (7) (8) Common Stock 47,448 (9) I By: Jerusalem Venture Partners Entrepreneurs Fund IV, L.P.(5)
Series AA Preferred Stock (7) (8) Common Stock 45,202 (9) I By: Jerusalem Venture Partners IV-A, L.P.(6)
Explanation of Responses:
1. The reportable securities are owned directly by Jerusalem Venture Partners IV, L.P. ("JVP IV"). Erel Margalit (the "Officer") is the officer of JVP Corp. IV ("JVP Corp"). JVP Corp is the general partner of Jerusalem Partners IV, L.P. ("JP IV"), which is the general partner of JVP IV. The Officer, JVP Corp and JP IV may be deemed to share voting and dispositive power over the shares held by JVP IV and disclaim beneficial ownership of shares held by JVP IV except to the extent of any pecuniary interest therein.
2. The reportable securities are owned directly by JVP IV Annex Fund, L.P. ("JVP IV AF"). The Officer is the officer of JVP Corp. JVP Corp is the general partner of JP Media V, L.P. ("JPM V"), which is the general partner of JVP IV AF. The Officer, JVP Corp and JPM V may be deemed to share voting and dispositive power over the shares held by JVP IV AF and disclaim beneficial ownership of shares held by JVP IV AF except to the extent of any pecuniary interest therein.
3. The reportable securities are owned directly by JVP IV Annex Entrepreneur Fund, L.P. ("JVP IV AEF"). The Officer is the officer of JVP Corp. JVP Corp is the general partner of JPM V, which is the general partner of JVP IV AEF. The Officer, JVP Corp and JPM V may be deemed to share voting and dispositive power over the shares held by JVP IV AEF and disclaim beneficial ownership of shares held by JVP IV AEF except to the extent of any pecuniary interest therein.
4. The reportable securities are owned directly by Jerusalem Venture Partners IV (Israel), L.P. ("JVP IV I"). The Officer is the officer of JVP Corp. JVP Corp is the general partner of Jerusalem Partners IV - Venture Capital, L.P. ("JP IV-VC"), which is the general partner of JVP IV I. The Officer, JVP Corp and JP IV-VC may be deemed to share voting and dispositive power over the shares held by JVP IV I and disclaim beneficial ownership of shares held by JVP IV I except to the extent of any pecuniary interest therein.
5. The reportable securities are owned directly by Jerusalem Venture Partners Entrepreneurs Fund IV, L.P. ("JVPEF IV"). The Officer is the officer of JVP Corp. JVP Corp is the general partner of JP IV, which is the general partner of JVPEF IV. The Officer, JVP Corp and JP IV may be deemed to share voting and dispositive power over the shares held by JVPEF IV and disclaim beneficial ownership of shares held by JVPEF IV except to the extent of any pecuniary interest therein.
6. The reportable securities are owned directly by Jerusalem Venture Partners IV-A, L.P. ("JVP IV-A"). The Officer is the officer of JVP Corp. JVP Corp is the general partner of JP IV, which is the general partner of JVP IV-A. The Officer, JVP Corp and JP IV may be deemed to share voting and dispositive power over the shares held by JVP IV-A and disclaim beneficial ownership of shares held by JVP IV-A except to the extent of any pecuniary interest therein.
7. Immediately.
8. Not Applicable.
9. Each outstanding share of preferred stock will automatically convert into 1 share of common stock, to occur upon the close of business of the day immediately preceding the closing of the issuer's initial public offering.
Remarks:
Since there are 11 joint filers with this transaction and EDGAR will not allow for entry of more than 10 joint filers, this Form 3 is being filed in conjunction with a Form 3 for Erel Margalit, Jerusalem Venture Partners IV, L.P., JVP IV Annex Fund, L.P., JVP IV Annex Entrepreneur Fund, L.P., Jerusalem Venture Partners IV (Israel), L.P., Jerusalem Venture Partners Entrepreneurs Fund IV, L.P., Jerusalem Venture Partners IV-A, L.P., Jerusalem Partners IV, L.P., JP Media V, L.P. and Jerusalem Partners IV - Venture Capital, L.P.
/s/ Erel Margalit, Authorized signatory for JVP Corp. IV 07/14/2010
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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