FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 10/11/2018 |
3. Issuer Name and Ticker or Trading Symbol
Anaplan, Inc. [ PLAN ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock, par value $0.0001 per share | 1,123,752 | D(1) | |
Common Stock, par value $0.0001 per share | 2,954,998 | I | See Footnote(2) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series A Convertible Preferred Stock | (3) | (3) | Common Stock, par value $0.0001 per share | 13,748 | (3) | D(1) | |
Series D Convertible Preferred Stock | (3) | (3) | Common Stock, par value $0.0001 per share | 3,865,889 | (3) | D(1) | |
Series E Convertible Preferred Stock | (3) | (3) | Common Stock, par value $0.0001 per share | 99,019 | (3) | D(1) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. The reported securities are held in the account of Coatue Private Fund I LP (the "Fund"), a private investment fund managed by Coatue Management, L.L.C. (the "Investment Manager"), and may be deemed to be beneficially owned by the Investment Manager, the general partner of the Fund, Coatue Hybrid GP I LLC (the "General Partner"), and by Philippe Laffont, managing member of the General Partner and who owns and controls the Investment Manager. |
2. The reported securities are held in the accounts of clients of the Investment Manager other than the Fund and may be deemed to be beneficially owned by the Investment Manager, as the investment manager to such clients, and Philippe Laffont who owns and controls the Investment Manager. |
3. The Series A, D and E convertible preferred stock is convertible into shares of the Issuer's Common Stock, par value $0.0001 per share ("Common Stock") on a 1-for-1 basis at any time at the holder's election and shall automatically convert into Common Stock immediately prior to the closing of the Issuer's initial public offering without payment of further consideration. The shares have no expiration date. |
Remarks: |
Each of the Fund, the Investment Manager, the General Partner and Philippe Laffont (collectively, the "Reporting Persons") disclaims beneficial ownership in the securities reported on this Form 3 except to the extent of its or his pecuniary interest, if any, therein, and this report shall not be deemed to be an admission that such Reporting Person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose. |
Coatue Private Fund I LP By: Coatue Hybrid GP I LLC its General Partner By: /s/ Philippe Laffont, Managing Member | 10/11/2018 | |
Coatue Management, L.L.C. By: /s/ Philippe Laffont, Authorized Person | 10/11/2018 | |
Coatue Hybrid GP I LLC By: /s/ Philippe Laffont, Managing Member | 10/11/2018 | |
/s/ Philippe Laffont | 10/11/2018 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |