0001181431-11-055525.txt : 20111109 0001181431-11-055525.hdr.sgml : 20111109 20111109130409 ACCESSION NUMBER: 0001181431-11-055525 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111108 FILED AS OF DATE: 20111109 DATE AS OF CHANGE: 20111109 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: IMPERVA INC CENTRAL INDEX KEY: 0001364962 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 030460133 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3400 BRIDGE PARKWAY, SUITE 200 CITY: REDWOOD SHORES STATE: CA ZIP: 94065 BUSINESS PHONE: 650-345-9000 MAIL ADDRESS: STREET 1: 3400 BRIDGE PARKWAY, SUITE 200 CITY: REDWOOD SHORES STATE: CA ZIP: 94065 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: STROHM DAVID N CENTRAL INDEX KEY: 0001182820 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35338 FILM NUMBER: 111190649 MAIL ADDRESS: STREET 1: EMC CORPORATION STREET 2: 176 SOUTH STREET CITY: HOPKINTON STATE: MA ZIP: 01748 4 1 rrd324567.xml FORM 4 X0304 4 2011-11-08 0 0001364962 IMPERVA INC IMPV 0001182820 STROHM DAVID N C/O IMPERVA, INC. 3400 BRIDGE PARKWAY, SUITE 200 REDWOOD SHORES CA 94065 1 0 0 0 Common Stock 2011-11-08 4 A 0 25000 18.00 A 75000 D Common Stock 18.00 2011-11-08 4 M 0 25000 0 D 2011-11-08 Common Stock 25000 0 D Includes 50,000 shares of common stock subject to a right of repurchase held by the Issuer, which will lapse according to the following schedule: the right of repurchase shall lapse on 25% of such shares on August 25, 2012 and the remainder shall lapse in 36 equal monthly installments thereafter. The right of repurchase on 100% of such shares still subject to repurchase shall lapse following a change in control of the Issuer. This common stock was granted under the Issuer's 2011 Stock Option and Incentive Plan on November 8, 2011 and is immediately exercisable. /s/ Tram Phi, by power of attorney 2011-11-08