0001181431-12-030038.txt : 20120515
0001181431-12-030038.hdr.sgml : 20120515
20120515180213
ACCESSION NUMBER: 0001181431-12-030038
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120515
FILED AS OF DATE: 20120515
DATE AS OF CHANGE: 20120515
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LARSON JOHN WILLIAM
CENTRAL INDEX KEY: 0001234387
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35232
FILM NUMBER: 12846699
MAIL ADDRESS:
STREET 1: C/O SANGAMO BIOSCIENCES IN STE.A-100
STREET 2: POINT RICHMOND TECH CENTER 501 CANA BLVD
CITY: RICHMOND
STATE: CA
ZIP: 94804
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: WAGEWORKS, INC.
CENTRAL INDEX KEY: 0001158863
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
IRS NUMBER: 943351864
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1100 PARK PLACE
STREET 2: 4TH FLOOR
CITY: SAN MATEO
STATE: CA
ZIP: 94403
BUSINESS PHONE: 650-557-5200
MAIL ADDRESS:
STREET 1: 1100 PARK PLACE
STREET 2: 4TH FLOOR
CITY: SAN MATEO
STATE: CA
ZIP: 94403
FORMER COMPANY:
FORMER CONFORMED NAME: WAGEWORKS INC
DATE OF NAME CHANGE: 20010907
4
1
rrd345248.xml
FORM 4
X0305
4
2012-05-15
0
0001158863
WAGEWORKS, INC.
WAGE
0001234387
LARSON JOHN WILLIAM
C/O WAGEWORKS, INC., 1100 PARK PLACE
4TH FLOOR
SAN MATEO
CA
94403
1
0
0
0
Common Stock
2012-05-15
4
C
0
64814
A
103460
D
Common Stock
2012-05-15
4
C
0
21459
A
124919
D
Common Stock
2012-05-15
4
C
0
7220
A
132139
D
Series A-1 Preferred Stock
2012-05-15
4
C
0
44074
0
D
Common Stock
64814
0
D
Series A-2 Preferred Stock
2012-05-15
4
C
0
25185
0
D
Common Stock
21459
0
D
Series D Preferred Stock
2012-05-15
4
C
0
14441
0
D
Common Stock
7220
0
D
Each share of the Issuer's Series A-1 preferred stock automatically converted into 1.47059 shares of common stock immediately prior to the closing of the Issuer's initial public offering and had no expiration date.
Each share of the Issuer's Series A-2 preferred stock automatically converted into 0.85208 shares of common stock immediately prior to the closing of the Issuer's initial public offering and had no expiration date.
Each share of the Issuer's Series D preferred stock automatically converted into 0.50 shares of common stock immediately prior to the closing of the Issuer's initial public offering and had no expiration date.
/s/ Kimberly L. Jackson, by power of attorney
2012-05-15