0001209191-15-041242.txt : 20150511 0001209191-15-041242.hdr.sgml : 20150511 20150511172219 ACCESSION NUMBER: 0001209191-15-041242 CONFORMED SUBMISSION TYPE: 4 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: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35840 FILM NUMBER: 15851881 MAIL ADDRESS: STREET 1: ELLIE MAE, INC. STREET 2: 4155 HOPYARD ROAD, SUITE 200 CITY: PLEASANTON STATE: CA ZIP: 94588 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2015-05-07 0 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 Common Stock 2015-05-07 4 A 0 12244 0.00 A 12244 D Common Stock 2015-05-07 4 A 0 2721 0.00 A 14965 D Issuable upon the vesting of Restricted Stock Units ("RSUs"). One-third (1/3) of the shares subject to this restricted stock unit grant will vest on each of May 15, 2016, May 15, 2017 and May 15, 2018, subject to the Reporting Person's continuing service on the Board of Directors through the applicable vesting dates. Issuable upon the vesting of RSUs. 25% of the shares subject to this RSU grant will vest quarterly on each of August 15, 2015, November 15, 2015, February 15, 2016, and May 15, 2016, provided that the Reporting Person continues to serve on the Board of Directors through the applicable vesting dates. /s/ Alan Henricks by Errol Hunter, Attorney-in-Fact 2015-05-11