0001628280-17-010672.txt : 20171102 0001628280-17-010672.hdr.sgml : 20171102 20171102160554 ACCESSION NUMBER: 0001628280-17-010672 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171031 FILED AS OF DATE: 20171102 DATE AS OF CHANGE: 20171102 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kalish Rami CENTRAL INDEX KEY: 0001720208 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38253 FILM NUMBER: 171172257 MAIL ADDRESS: STREET 1: C/O FORESCOUT TECHNOLOGIES INC STREET 2: 190 WEST TASMAN DRIVE CITY: SAN JOSE STATE: CA ZIP: 95134 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FORESCOUT TECHNOLOGIES, INC CENTRAL INDEX KEY: 0001145057 STANDARD INDUSTRIAL CLASSIFICATION: COMPUTER PERIPHERAL EQUIPMENT, NEC [3577] IRS NUMBER: 510406800 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 900 E. HAMILTON AVE #300 CITY: CAMPBELL STATE: CA ZIP: 95008 BUSINESS PHONE: 866-377-8771 MAIL ADDRESS: STREET 1: 900 E. HAMILTON AVE #300 CITY: CAMPBELL STATE: CA ZIP: 95008 FORMER COMPANY: FORMER CONFORMED NAME: FORESCOUT TECHNOLOGIES INC DATE OF NAME CHANGE: 20010717 4 1 wf-form4_150965313326154.xml FORM 4 X0306 4 2017-10-31 0 0001145057 FORESCOUT TECHNOLOGIES, INC FSCT 0001720208 Kalish Rami 11 HAMENOFIM STREET, BUILDING B HERZELIYA L3 46725 ISRAEL 1 0 1 0 Common Stock 2017-10-31 4 C 0 2476816 A 2526405 I See footnote Common Stock 2017-10-31 4 C 0 228953 A 233536 I See footnote Common Stock 2017-10-31 4 C 0 669726 A 683134 I See footnote Common Stock 2017-10-31 4 C 0 87182 A 88926 I See footnote Common Stock 2017-10-31 4 C 0 338330 A 345533 I See footnote Common Stock 2017-10-31 4 C 0 174319 A 177808 I See footnote Series B Convertible Preferred Stock 2017-10-31 4 C 0 14031 0 D Common Stock 739998.0 0 I See footnote Series B Convertible Preferred Stock 2017-10-31 4 C 0 1297 0 D Common Stock 68404.0 0 I See footnote Series B Convertible Preferred Stock 2017-10-31 4 C 0 3794 0 D Common Stock 200096.0 0 I See footnote Series B Convertible Preferred Stock 2017-10-31 4 C 0 494 0 D Common Stock 26053.0 0 I See footnote Series B Convertible Preferred Stock 2017-10-31 4 C 0 4090 0 D Common Stock 215707.0 0 I See footnote Series B Convertible Preferred Stock 2017-10-31 4 C 0 988 0 D Common Stock 52106.0 0 I See footnote Series C Convertible Preferred Stock 2017-10-31 4 C 0 5259 0 D Common Stock 277358.0 0 I See footnote Series C Convertible Preferred Stock 2017-10-31 4 C 0 486 0 D Common Stock 25630.0 0 I See footnote Series C Convertible Preferred Stock 2017-10-31 4 C 0 1422 0 D Common Stock 74995.0 0 I See footnote Series C Convertible Preferred Stock 2017-10-31 4 C 0 185 0 D Common Stock 9756.0 0 I See footnote Series C Convertible Preferred Stock 2017-10-31 4 C 0 369 0 D Common Stock 19460.0 0 I See footnote Series D Convertible Preferred Stock 2017-10-31 4 C 0 753146 0 D Common Stock 753146.0 0 I See footnote Series D Convertible Preferred Stock 2017-10-31 4 C 0 69623 0 D Common Stock 69623.0 0 I See footnote Series D Convertible Preferred Stock 2017-10-31 4 C 0 203649 0 D Common Stock 203649.0 0 I See footnote Series D Convertible Preferred Stock 2017-10-31 4 C 0 26511 0 D Common Stock 26511.0 0 I See footnote Series D Convertible Preferred Stock 2017-10-31 4 C 0 41853 0 D Common Stock 41853.0 0 I See footnote Series D Convertible Preferred Stock 2017-10-31 4 C 0 53028 0 D Common Stock 53028.0 0 I See footnote Series D-1 Convertible Preferred Stock 2017-10-31 4 C 0 151186 0 D Common Stock 151186.0 0 I See footnote Series D-1 Convertible Preferred Stock 2017-10-31 4 C 0 13976 0 D Common Stock 13976.0 0 I See footnote Series D-1 Convertible Preferred Stock 2017-10-31 4 C 0 40880 0 D Common Stock 40880.0 0 I See footnote Series D-1 Convertible Preferred Stock 2017-10-31 4 C 0 5322 0 D Common Stock 5322.0 0 I See footnote Series D-1 Convertible Preferred Stock 2017-10-31 4 C 0 10643 0 D Common Stock 10643.0 0 I See footnote Series E Convertible Preferred Stock 2017-10-31 4 C 0 555128 0 D Common Stock 555128.0 0 I See footnote Series E Convertible Preferred Stock 2017-10-31 4 C 0 51320 0 D Common Stock 51320.0 0 I See footnote Series E Convertible Preferred Stock 2017-10-31 4 C 0 150106 0 D Common Stock 150106.0 0 I See footnote Series E Convertible Preferred Stock 2017-10-31 4 C 0 19540 0 D Common Stock 19540.0 0 I See footnote Series E Convertible Preferred Stock 2017-10-31 4 C 0 80770 0 D Common Stock 80770.0 0 I See footnote Series E Convertible Preferred Stock 2017-10-31 4 C 0 39082 0 D Common Stock 39082.0 0 I See footnote The Series B Convertible Preferred Stock automatically converted into Common Stock on an approximate 1:52.7 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date. The Series C Convertible Preferred Stock automatically converted into Common Stock on an approximate 1:52.7 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date. The Series D Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date. The Series D-1 Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date. The Series E Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date. The shares are held of record by Pitango Venture Capital Fund III (USA) L.P. ("Fund III USA"). Pitango V.C. Fund III General Partner ("Pitango GP"), the general partner of Fund III USA, has sole voting and dispositive power with respect to the shares held by Fund III USA. The reporting person shares voting and dispositive power with respect to the shares held by Pitango GP and disclaims beneficial ownership of the securities held by Fund III USA except to the extent of any pecuniary interest therein. The shares are held of record by Pitango Venture Capital Fund III (USA) Non-Q L.P. ("Fund III USA Non-Q"). Pitango GP, the general partner of Fund III USA Non-Q, has sole voting and dispositive power with respect to the shares held by Fund III USA Non-Q. The reporting person shares voting and dispositive power with respect to the shares held by Pitango GP and disclaims beneficial ownership of the securities held by Fund III USA Non-Q except to the extent of any pecuniary interest therein. The shares are held of record by Pitango Venture Capital Fund III (Israeli Investors) L.P. ("Fund III Israeli Investors"). Pitango GP, the general partner of Fund III Israeli Investors, has sole voting and dispositive power with respect to the shares held by Fund III Israeli Investors. The reporting person shares voting and dispositive power with respect to the shares held by Pitango GP and disclaims beneficial ownership of the securities held by Fund III Israeli Investors except to the extent of any pecuniary interest therein. The shares are held of record by Pitango Principals Fund III (USA) L.P. ("Principals Fund III"). Pitango GP, the general partner of Principals Fund III, has sole voting and dispositive power with respect to the shares held by Principals Fund III. The reporting person shares voting and dispositive power with respect to the shares held by Pitango GP and disclaims beneficial ownership of the securities held by Principals Fund III except to the extent of any pecuniary interest therein. The shares are held of record by Pitango Parallel Investor Fund III (USA) L.P ("Parallel Investor Fund"). Pitango GP, the general partner of Parallel Investor Fund, has sole voting and dispositive power with respect to the shares held by Parallel Investor Fund. The reporting person shares voting and dispositive power with respect to the shares held by Pitango GP and disclaims beneficial ownership of the securities held by Parallel Investor Fund except to the extent of any pecuniary interest therein. The shares are held of record by Pitango Venture Capital Fund III Trusts 2000 Ltd ("Capital Fund 2000"). Capital Fund 2000 is owned and controlled indirectly by the Principals which holds shares of the Issuer in trust for three limited partnerships: Pitango CEO Fund III (USA) L.P., Pitango CEO Fund III (Israel) L.P. and Pitango Family Fund III (Israel) L.P. These three limited partnerships are managed by their sole general partner, the GP. Pitango GP, the general partner of Parallel Investor Fund, has sole voting and dispositive power with respect to the shares held by Capital Fund 2000. The partners of Pitango GP are eight private companies that are each owned by one of the Principals, share voting and dispositive power with respect to the shares held by Capital Fund 2000. The reporting person shares voting and dispositive power with respect to the shares held by Pitango GP and disclaims beneficial ownership of the securities held by Capital Fund 2000 except to the extent of any pecuniary interest therein. This report on Form 4 is the first of two reports relating to the same transaction. /s/ Rami Kalish 2017-11-02