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