0000899243-17-003653.txt : 20170210 0000899243-17-003653.hdr.sgml : 20170210 20170210202837 ACCESSION NUMBER: 0000899243-17-003653 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170210 FILED AS OF DATE: 20170210 DATE AS OF CHANGE: 20170210 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MODEL N, INC. CENTRAL INDEX KEY: 0001118417 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370] IRS NUMBER: 770528806 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 1600 SEAPORT BOULEVARD STREET 2: SUITE 400 CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: (650) 610-4600 MAIL ADDRESS: STREET 1: 1600 SEAPORT BOULEVARD STREET 2: SUITE 400 CITY: REDWOOD CITY STATE: CA ZIP: 94063 FORMER COMPANY: FORMER CONFORMED NAME: MODEL T1 INC DATE OF NAME CHANGE: 20001031 FORMER COMPANY: FORMER CONFORMED NAME: MODEL N INC DATE OF NAME CHANGE: 20000707 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rinat Zack CENTRAL INDEX KEY: 0001571039 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35840 FILM NUMBER: 17595424 MAIL ADDRESS: STREET 1: C/O MODEL N, INC. STREET 2: 1600 SEAPORT BOULEVARD SUITE 400 CITY: REDWOOD CITY STATE: CA ZIP: 94063 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-02-10 0 0001118417 MODEL N, INC. MODN 0001571039 Rinat Zack C/O MODEL N, INC. 1600 SEAPORT BOULEVARD, STE 400 REDWOOD CITY CA 94063 1 1 1 0 CEO and Executive Chairman Common Stock 2285205 D Common Stock 2017-02-10 4 P 0 2905 10.09 A 26907 I By GADD, Inc. Common Stock 666666 I By the Danielle Rinat Family Heritage Trust dated December 12, 2005 Common Stock 666666 I By the Gahl Rinat Family Heritage Trust Dated December 12, 2005 Common Stock 36310 I By the Gahl Rinat Trust Common Stock 36311 I By the Danielle Rinat Trust Common Stock 1666666 I By the Rinat Family 2006 Trust Dated December 13, 2006 Includes an additional 72,667 and 34,666, and a net loss of 28,667 shares of common stock issued upon the vesting of Performance-Based RSUs ("PB-RSUs") granted to the Reporting Person on December 6, 2013 in connection with the achievement of 209%, 152% and 57%, respectively, of certain performance criteria related to the Reporting Person's PB-RSUs. Represents a weighted average purchase price per share. These shares were purchased in multiple transactions at prices ranging from $9.85 to $10.10. The reporting person undertakes to provide to the Issuer, the staff of the Securities and Exchange Commission or any security holder of the Issuer, upon request, full information regarding the number of shares purchased at each separate price within the range. Mr. Rinat is the sole director and Chief Executive Officer of GADD, Inc. ("GADD"). Mr. Rinat and Orli Rinat are trustees of the Rinat Family 2006 Trust Dated December 13, 2006 (the "Trust"). The Trust is the sole shareholder of GADD. Accordingly, Mr. Rinat may be deemed the beneficial owner of all shares held by the Trust and GADD. /s/ Zack Rinat by Errol Hunter, Attorney-in-Fact 2017-02-10