0001062993-21-002681.txt : 20210312
0001062993-21-002681.hdr.sgml : 20210312
20210312173954
ACCESSION NUMBER: 0001062993-21-002681
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210310
FILED AS OF DATE: 20210312
DATE AS OF CHANGE: 20210312
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LEONE DOUGLAS M
CENTRAL INDEX KEY: 0001195580
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38982
FILM NUMBER: 21738785
MAIL ADDRESS:
STREET 1: C/O SEQUOIA CAPITAL
STREET 2: 2800 SAND HILL RD, SUITE 101
CITY: MENLO PARK
STATE: CA
ZIP: 94025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Medallia, Inc.
CENTRAL INDEX KEY: 0001540184
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0131
BUSINESS ADDRESS:
STREET 1: 575 MARKET STREET
STREET 2: SUITE 1850
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
BUSINESS PHONE: (650) 321-3000
MAIL ADDRESS:
STREET 1: 575 MARKET STREET
STREET 2: SUITE 1850
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
FORMER COMPANY:
FORMER CONFORMED NAME: Medallia Inc.
DATE OF NAME CHANGE: 20120123
4
1
form4.xml
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
X0306
4
2021-03-10
0001540184
Medallia, Inc.
MDLA
0001195580
LEONE DOUGLAS M
2800 SAND HILL ROAD, SUITE 101
MENLO PARK
CA
94025
1
0
1
0
Common Stock
2021-03-10
4
J
0
180720
0
A
180720
I
By estate planning vehicle
Common Stock
405806
D
Common Stock
1425
I
Denarvor, L.L.C.
Common Stock
25226945
I
SC US GF V Holdings, Ltd.
Common Stock
9713752
I
Sequoia Capital U.S. Growth Fund VI, L.P.
Common Stock
486555
I
Sequoia Capital U.S. Growth VI Principals Fund, L.P.
Common Stock
8726574
I
Sequoia Capital Global Growth Fund, LP
Common Stock
253230
I
Sequoia Capital Global Growth Principals Fund, LP
These shares were received as part of a pro rata distribution-in-kind to the limited partners of an investment fund in which the reporting person's estate planning vehicle is a limited partner.
SC US SSF 2013 (TTGP), L.L.C. is the general partner of SC U.S. Scout Seed Fund 2013 Management, L.P., which is the general partner of Sequoia Capital U.S. Scout Seed Fund 2013, L.P., which wholly owns Sequoia Capital U.S. Scout Fund IV, L.L.C., which in turn wholly owns Denarvor, L.L.C. Voting and dispositive decisions at SC US SSF 2013 (TTGP), L.L.C. with respect to the shares held by Denarvor, L.L.C. are made by an investment committee that includes Mr. Leone.
Mr. Leone disclaims beneficial ownership of the securities held by Denarvor, L.L.C., SC US GF V Holdings, Ltd., Sequoia Capital U.S. Growth Fund VI, L.P., Sequoia Capital U.S. Growth VI Principals Fund, L.P., Sequoia Capital Global Growth Fund, LP and Sequoia Capital Global Growth Principals Fund, LP except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.
SC US (TTGP), Ltd. is the general partner of SCGF V Management, L.P., which is the general partner of Sequoia Capital U.S. Growth Fund V, LP and Sequoia Capital USGF Principals Fund V, L.P., or collectively, the SC US GF V Funds, which together own 100% of the outstanding shares of SC US GF V Holdings, Ltd. Voting and dispositive decisions at SC US (TTGP), Ltd. with respect to the shares held by SC US GF V Holdings, Ltd. are made by an investment committee that includes Mr. Leone.
SC US (TTGP), Ltd. is the general partner of SC U.S. Growth VI Management, L.P., which is the general partner of Sequoia Capital U.S. Growth Fund VI, L.P. and Sequoia Capital U.S. Growth VI Principals Fund, L.P. Voting and dispositive decisions at SC US (TTGP), Ltd. with respect to the shares held by Sequoia Capital U.S. Growth Fund VI, L.P. and Sequoia Capital U.S. Growth VI Principals Fund, L.P. are made by an investment committee that includes Mr. Leone.
SC US (TTGP), Ltd. is the general partner of SCGGF Management, L.P., which is the general partner of Sequoia Capital Global Growth Fund, LP and Sequoia Capital Global Growth Principals Fund, LP. Voting and dispositive decisions at SC US (TTGP), Ltd. with respect to the shares held by Sequoia Capital Global Growth Fund, LP and Sequoia Capital Global Growth Principals Fund, LP. are made by an investment committee that includes Mr. Leone.
/s/ Jung Yeon Son, Attorney-in-fact for Douglas M. Leone
2021-03-12