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