0001667731-17-000070.txt : 20170217
0001667731-17-000070.hdr.sgml : 20170217
20170217184244
ACCESSION NUMBER: 0001667731-17-000070
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170217
FILED AS OF DATE: 20170217
DATE AS OF CHANGE: 20170217
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: Fisher Melissa B
CENTRAL INDEX KEY: 0001570337
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35840
FILM NUMBER: 17622896
MAIL ADDRESS:
STREET 1: 188 E. 64TH STREET
STREET 2: APT. 604
CITY: NEW YORK
STATE: NY
ZIP: 10065
4
1
fisher20170217.xml
X0306
4
2017-02-17
0
0001118417
MODEL N, INC.
MODN
0001570337
Fisher Melissa B
C/O MODEL N, INC.
1600 SEAPORT BLVD., STE. 400
REDWOOD CITY
CA
94063
1
0
0
0
Common Stock
2017-02-17
4
A
0
15873
0.00
A
21586
D
Issuable upon vesting of Restricted Stock Units ("RSUs"). 25% of the shares subject to this RSU grant will vest quarterly on each of May 15, 2017, August 15, 2017, November 15, 2017 and February 15, 2018, provided the Reporting Person continues to serve on the Board of Directors through the applicable vesting dates.
/s/ Melissa Fisher by Errol Hunter, Attorney-in-Fact
2017-02-17