0001758947-18-000004.txt : 20181213 0001758947-18-000004.hdr.sgml : 20181213 20181213210320 ACCESSION NUMBER: 0001758947-18-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181211 FILED AS OF DATE: 20181213 DATE AS OF CHANGE: 20181213 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Yarnold Dave CENTRAL INDEX KEY: 0001758947 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35840 FILM NUMBER: 181234413 MAIL ADDRESS: STREET 1: C/O MODEL N, INC. STREET 2: 777 MARINERS ISLAND BLVD, SUITE 300 CITY: SAN MATEO STATE: CA ZIP: 94404 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_154475298424996.xml FORM 4 X0306 4 2018-12-11 0 0001118417 MODEL N, INC. MODN 0001758947 Yarnold Dave C/O MODEL N 777 MARINERS ISLAND DRIVE, SUITE 300 SAN MATEO CA 94404 1 0 0 0 Common Stock 2018-12-11 4 A 0 1759 0 A 1759 D Issuable upon the vesting of Restricted Stock Units ("RSUs"). 100% of the shares subject to this RSU grant will vest on February 15, 2019, provided the Reporting Person continues to serve on the Board of Directors through the applicable vesting date. Dave Yarnold by Errol Hunter, Attorney-in-Fact 2018-12-13