0001209191-15-041232.txt : 20150511
0001209191-15-041232.hdr.sgml : 20150511
20150511171509
ACCESSION NUMBER: 0001209191-15-041232
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150507
FILED AS OF DATE: 20150511
DATE AS OF CHANGE: 20150511
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: Henricks Alan S.
CENTRAL INDEX KEY: 0001513957
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35840
FILM NUMBER: 15851800
MAIL ADDRESS:
STREET 1: ELLIE MAE, INC.
STREET 2: 4155 HOPYARD ROAD, SUITE 200
CITY: PLEASANTON
STATE: CA
ZIP: 94588
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2015-05-07
1
0001118417
MODEL N, INC.
MODN
0001513957
Henricks Alan S.
C/O MODEL N, INC.
1600 SEAPORT BOULEVARD, SUITE 400
REDWOOD CITY
CA
94063
1
0
0
0
/s/ Alan Henricks by Errol Hunter, Attorney-in-Fact
2015-05-11