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