0001118417-20-000073.txt : 20200519
0001118417-20-000073.hdr.sgml : 20200519
20200519214118
ACCESSION NUMBER: 0001118417-20-000073
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200516
FILED AS OF DATE: 20200519
DATE AS OF CHANGE: 20200519
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Adams Timothy M
CENTRAL INDEX KEY: 0001298669
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35840
FILM NUMBER: 20895562
MAIL ADDRESS:
STREET 1: 311 ARSENAL STREET
CITY: WATERTOWN
STATE: MA
ZIP: 02472
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: 777 MARINERS ISLAND BOULEVARD
STREET 2: SUITE 300
CITY: SAN MATEO
STATE: CA
ZIP: 94404
BUSINESS PHONE: (650) 610-4600
MAIL ADDRESS:
STREET 1: 777 MARINERS ISLAND BOULEVARD
STREET 2: SUITE 300
CITY: SAN MATEO
STATE: CA
ZIP: 94404
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
4
1
wf-form4_158993886134510.xml
FORM 4
X0306
4
2020-05-16
0
0001118417
MODEL N, INC.
MODN
0001298669
Adams Timothy M
C/O MODEL N, INC.
777 MARINERS ISLAND BOULEVARD, SUITE 300
SAN MATEO
CA
94404
1
0
0
0
Common Stock
2020-05-16
4
A
0
124
0
A
45400
D
In connection with the Reporting Person's transition from serving as the Chair of the Issuer's Nominating and Corporate Governance Committee to serving as a member of the Issuer's Nominating and Corporate Governance Committee, 179 unvested restricted stock units (RSUs) previously granted to the Reporting Person for service as the Chair of the Nominating and Corporate Governance Committee were cancelled and 124 RSUs for service as a member of the Nominating and Corporate Governance Committee were granted. The amount of securities reported in this column represents shares of common stock issuable upon the vesting of the new RSU award, which vests in three equal installments on August 15, 2020, November 15, 2020, and February 15, 2021 provided the Reporting Person continues to serve on the Nominating and Corporate Governance Committee through the applicable vest date.
Since the date of the Reporting Person's last ownership report, 179 unvested RSUs previously granted to the Reporting Person were cancelled for no value as described in footnote 1.
/s/ Tim Adams by Errol Hunter, Attorney-in-Fact
2020-05-19