0001118417-24-000043.txt : 20240216 0001118417-24-000043.hdr.sgml : 20240216 20240216200933 ACCESSION NUMBER: 0001118417-24-000043 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240215 FILED AS OF DATE: 20240216 DATE AS OF CHANGE: 20240216 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Adams Timothy M CENTRAL INDEX KEY: 0001298669 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35840 FILM NUMBER: 24650307 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] ORGANIZATION NAME: 06 Technology 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 wk-form4_1708132153.xml FORM 4 X0508 4 2024-02-15 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 0 Common Stock 2024-02-15 4 A 0 7176 0 A 27311 D Issuable upon the vesting of Restricted Stock Units ("RSUs"). 25% of the shares subject to this RSU grant will vest on May 15, 2024, August 15, 2024, November 15, 2024, and February 15, 2025, provided the Reporting Person continues to serve on the Board of Directors through the applicable vesting date. /s/ Timothy M. Adams by Errol Hunter, Attorney-in-Fact 2024-02-16