0001118417-22-000102.txt : 20220818 0001118417-22-000102.hdr.sgml : 20220818 20220818210346 ACCESSION NUMBER: 0001118417-22-000102 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220816 FILED AS OF DATE: 20220818 DATE AS OF CHANGE: 20220818 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Anderson, Mark, Albert CENTRAL INDEX KEY: 0001671704 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35840 FILM NUMBER: 221178793 BUSINESS ADDRESS: STREET 1: C/O MODEL N, INC.,1600 SEAPORT BOULEVARD STREET 2: SUITE 400, PACIFIC SHORES CENTER - BLD.6 CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 650-610-4600 MAIL ADDRESS: STREET 1: C/O MODEL N, INC.,1600 SEAPORT BOULEVARD STREET 2: SUITE 400, PACIFIC SHORES CENTER - BLD.6 CITY: REDWOOD CITY STATE: CA ZIP: 94063 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_166087101268554.xml FORM 4 X0306 4 2022-08-16 0 0001118417 MODEL N, INC. MODN 0001671704 Anderson, Mark, Albert C/O MODEL N, INC. 777 MARINERS ISLAND BOULEVARD, SUITE 300 SAN MATEO CA 94404 0 1 0 0 Chief Services Officer Common Stock 2022-08-16 4 S 0 290 31.65 D 175855 D Common Stock 2022-08-16 4 S 0 301 31.65 D 175554 D Common Stock 2022-08-16 4 S 0 112 31.65 D 175442 D Common Stock 2022-08-16 4 S 0 267 31.65 D 175175 D Common Stock 2022-08-16 4 S 0 444 31.65 D 174731 D All shares reported as disposed of in this transaction were sold by the Reporting Person in order to pay the federal and state tax withholding obligations resulting from the vesting of the Reporting Person's Restricted Stock Units ("RSUs") and/or performance-based RSUs. The Reporting Person did not sell or otherwise dispose of any of the shares reported in this transaction for any reason other than to cover required taxes. Reflects a decrease of 204 shares of unvested Performance-Based RSUs ("PB-RSUs") that were cancelled due to the achievement of 64.9% of certain performance criteria related to PB-RSUs granted to the Reporting Person on November 22, 2019. /s/Mark Anderson by Errol Hunter, Attorney-in-Fact 2022-08-18