0001181431-12-032154.txt : 20120523
0001181431-12-032154.hdr.sgml : 20120523
20120523202231
ACCESSION NUMBER: 0001181431-12-032154
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120521
FILED AS OF DATE: 20120523
DATE AS OF CHANGE: 20120523
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BREYER JAMES
CENTRAL INDEX KEY: 0001194696
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35338
FILM NUMBER: 12865559
MAIL ADDRESS:
STREET 1: ACCEL PARTNERS
STREET 2: 428 UNIVERSITY AVE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PATTERSON ARTHUR C
CENTRAL INDEX KEY: 0001219233
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35338
FILM NUMBER: 12865557
MAIL ADDRESS:
STREET 1: 428 UNIVERSITY AVE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SWARTZ JAMES R
CENTRAL INDEX KEY: 0001219237
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35338
FILM NUMBER: 12865556
MAIL ADDRESS:
STREET 1: P O BOX 2816
CITY: PARK CIRY
STATE: UT
ZIP: 84060
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ACCEL VIII LP
CENTRAL INDEX KEY: 0001115786
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35338
FILM NUMBER: 12865562
BUSINESS ADDRESS:
STREET 1: ONE PALMER SQUARE
CITY: PRINCETON
STATE: NJ
ZIP: 08542
MAIL ADDRESS:
STREET 1: 428 UNIVERSITYI AVENUE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ACCEL INTERNET FUND IV LP
CENTRAL INDEX KEY: 0001119932
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35338
FILM NUMBER: 12865561
BUSINESS ADDRESS:
STREET 1: ONE PALMER SQUARE
CITY: PRINCETON
STATE: NJ
ZIP: 08542
MAIL ADDRESS:
STREET 1: 428 UNIVERSITY AVENUE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ACCEL INVESTORS 2002 LLC
CENTRAL INDEX KEY: 0001248474
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35338
FILM NUMBER: 12865560
BUSINESS ADDRESS:
STREET 1: 428 UNIVERSITY AVENUE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
BUSINESS PHONE: 6506144800
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ACCEL VIII ASSOCIATES LLC
CENTRAL INDEX KEY: 0001248538
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35338
FILM NUMBER: 12865558
BUSINESS ADDRESS:
STREET 1: 428 UNIVERSITY AVENUE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
BUSINESS PHONE: 6506144800
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: IMPERVA INC
CENTRAL INDEX KEY: 0001364962
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 030460133
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3400 BRIDGE PARKWAY, SUITE 200
CITY: REDWOOD SHORES
STATE: CA
ZIP: 94065
BUSINESS PHONE: 650-345-9000
MAIL ADDRESS:
STREET 1: 3400 BRIDGE PARKWAY, SUITE 200
CITY: REDWOOD SHORES
STATE: CA
ZIP: 94065
4
1
rrd346373.xml
FORM 4
X0305
4
2012-05-21
1
0001364962
IMPERVA INC
IMPV
0001115786
ACCEL VIII LP
ACCEL PARTNERS
428 UNIVERSITY AVENUE
PALO ALTO
CA
94301
0
0
1
0
0001119932
ACCEL INTERNET FUND IV LP
ACCEL PARTNERS
428 UNIVERSITY AVENUE
PALO ALTO
CA
94301
0
0
1
0
0001248474
ACCEL INVESTORS 2002 LLC
ACCEL PARTNERS
428 UNIVERSTIY AVENUE
PALO ALTO
CA
94301
0
0
1
0
0001194696
BREYER JAMES
C/O ACCEL PARTNERS
428 UNIVERSITY AVENUE
PALO ALTO
CA
94301
0
0
1
0
0001248538
ACCEL VIII ASSOCIATES LLC
C/O ACCEL PARTNERS
428 UNIVERSITY AVENUE
PALO ALTO
CA
94301
0
0
1
0
0001219233
PATTERSON ARTHUR C
C/O ACCEL PARTNERS
428 UNIVERSITY AVENUE
PALO ALTO
CA
94301
0
0
1
0
0001219237
SWARTZ JAMES R
C/O ACCEL PARTNERS
428 UNIVERSITY AVE
PALO ALTO
CA
94301
0
0
1
0
Common Stock
2012-05-21
4
J
0
1599607
0
D
1599607
D
Common Stock
2012-05-21
4
J
0
314216
0
D
314216
I
See footnote
Common Stock
2012-05-21
4
J
0
138534
0
D
138534
I
See footnote
Common Stock
2012-05-21
4
J
0
41558
0
A
41558
I
By Brookline Living Trust
Common Stock
2012-05-21
4
J
0
70174
0
A
70174
I
By James W. Breyer 2005 Trust
Common Stock
2012-05-21
4
J
0
15352
0
A
15352
I
By James R. Swartz
Common Stock
2012-05-21
4
J
0
24358
0
A
24358
I
By Homestake Partners L.P.
Common Stock
2012-05-21
4
J
0
797
0
A
797
I
By Pacific Starbuck LLC
Common Stock
2012-05-21
4
J
0
34805
0
A
34805
I
By Burn3 LLC
Common Stock
2012-05-21
4
J
0
25588
0
A
25588
I
By Ellmore C. Patterson Partners
Common Stock
2012-05-21
4
J
0
5118
0
A
5118
I
By ACP Family Partnership L.P.
Common Stock
2012-05-21
4
J
0
77230
0
A
77230
I
By ACP 2007 ACCEL-7 GRAT U/A/D 4/2/07
Represents a pro rata distribution by Accel VIII L.P., Accel Investors 2002 L.L.C. and Accel Internet Fund IV L.P. to their respective general and limited partners or members without consideration.
The securities are held by Accel VIII L.P. Accel VIII Associates L.L.C. ("A8A") is the General Partner of Accel VIII L.P. and has the sole voting and investment power with respect to the shares. James W. Breyer, Arthur C. Patterson, Theresia Gouw Ranzetta, a director of the Issuer, and James R. Swartz are the Managing Members of and share voting and investment powers in such entities. Each Reporting Person disclaims beneficial ownership of all shares held by the foregoing entities except to the extent of its pecuniary interest therein.
The securities are held by Accel Internet Fund IV L.P. A8A is the General Partner of Accel Internet Fund IV L.P. and has the sole voting and investment power with respect to those entities. James W. Breyer, Arthur C. Patterson, Theresia Gouw Ranzetta, a director of the Issuer, and James R. Swartz are the Managing Members of and share voting and investment powers in such entities. Each Reporting Person disclaims beneficial ownership of all shares held by the foregoing entities except to the extent of its pecuniary interest therein.
The securities are held by Accel Investors 2002 L.L.C. ("AI2002"). James W. Breyer, Arthur C. Patterson, Theresia Gouw Ranzetta, a director of the Issuer, and James R. Swartz are the Managing Members of and share voting and investment powers in such entities. Each Reporting Person disclaims beneficial ownership of all shares held by the foregoing entities except to the extent of its pecuniary interest therein.
Shares are directly owned by the Brookline Living Trust, dated August 7, 2003. Theresia Gouw Ranzetta is a Trustee of the Trust and shares voting and investment powers. Theresia Gouw Ranzetta disclaims beneficial ownership except to the extent of her pecuniary interest therein.
Shares are directly owned by the James W. Breyer 2005 Trust dated March 25, 2005. James W. Breyer is a Trustee of the Trust and shares voting and investment powers. Mr. Breyer disclaims beneficial ownership except to the extent of his pecuniary interest therein.
Shares are directly owned by James R. Swartz.
Shares are directly owned by the Homestake Partners L.P. James R. Swartz is a General Partner of Homestake Partners L.P. and has voting and investment powers with respect to such shares. Mr. Swartz disclaims beneficial ownership except to the extent of his pecuniary interest therein.
Shares are directly owned by Pacific Starbuck LLC. Arthur C. Patterson and James R. Swartz are managing members of Pacific Starbuck LLC and share voting and investment powers. Messrs. Patterson and Swartz disclaim beneficial ownership except to the extent of their pecuniary interests therein.
Shares are directly owned by Burn3 LLC. James R. Swartz is a Manager of Burn3 LLC and has voting and investment powers with respect to such shares. Mr. Swartz disclaims beneficial ownership except to the extent of his pecuniary interest therein.
Shares are directly owned by Ellmore C. Patterson Partners L.P. Arthur C. Patterson is a Manager of the general partner of Ellmore C. Patterson Partners L.P. and has voting and investment power with respect to such shares. Mr. Patterson disclaims beneficial ownership except to the extent of his pecuniary interest therein.
Shares are directly owned by the ACP Family Partnership L.P. Immediate family members of Arthur C. Patterson are beneficial holders of ACP Family Partnership L.P., and Mr. Patterson may be deemed to exercise voting and investment power over such shares. Mr. Patterson disclaims beneficial ownership except to the extent of his pecuniary interest therein.
Shares are directly owned by ACP 2007 ACCEL-7 GRAT U/A/D 4/2/07. Arthur C. Patterson is a Trustee of the Trust and shares voting and investment powers. Mr. Patterson disclaims beneficial ownership except to the extent of his pecuniary interest therein.
/s/ Tracy L. Sedlock, attorney in fact to Reporting Person
2012-05-23