0001200925-19-000031.txt : 20190923
0001200925-19-000031.hdr.sgml : 20190923
20190923182359
ACCESSION NUMBER: 0001200925-19-000031
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190919
FILED AS OF DATE: 20190923
DATE AS OF CHANGE: 20190923
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MADER MARK PATRICK
CENTRAL INDEX KEY: 0001200925
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38464
FILM NUMBER: 191108900
MAIL ADDRESS:
STREET 1: 3514 45TH AVE NE
CITY: SEATTLE
STATE: WA
ZIP: 98105
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: SMARTSHEET INC
CENTRAL INDEX KEY: 0001366561
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 202954357
STATE OF INCORPORATION: WA
FISCAL YEAR END: 0131
BUSINESS ADDRESS:
STREET 1: 10500 NE 8TH STREET
STREET 2: SUITE 1300
CITY: BELLEVUE
STATE: WA
ZIP: 98004
BUSINESS PHONE: 855-420-2395
MAIL ADDRESS:
STREET 1: 10500 NE 8TH STREET
STREET 2: SUITE 1300
CITY: BELLEVUE
STATE: WA
ZIP: 98004
FORMER COMPANY:
FORMER CONFORMED NAME: SMARTSHEET.COM INC
DATE OF NAME CHANGE: 20060619
4
1
wf-form4_156927741886579.xml
FORM 4
X0306
4
2019-09-19
0
0001366561
SMARTSHEET INC
SMAR
0001200925
MADER MARK PATRICK
C/O SMARTSHEET INC.
10500 NE 8TH ST., SUITE 1300
BELLEVUE
WA
98004
1
1
0
0
President and CEO
Class A Common Stock
2019-09-19
4
C
0
989254
A
991757
D
Class A Common Stock
2019-09-19
4
C
0
50000
A
116250
I
By T77A Trust
Class A Common Stock
2019-09-19
4
C
0
50000
A
116250
I
By T49C Trust
Class B Common Stock
2019-09-19
4
C
0
989254
0
D
Class A Common Stock
989254.0
0
D
Class B Common Stock
2019-09-19
4
C
0
50000
0
D
Class A Common Stock
50000.0
0
I
By T77A Trust
Class B Common Stock
2019-09-19
4
C
0
50000
0
D
Class A Common Stock
50000.0
0
I
By T49C Trust
Stock Option (right to buy Class B Common Stock)
0.98
2019-09-19
4
J
0
51654
0
D
2024-02-21
Class B Common Stock
51654.0
0
D
Stock Option (right to buy Class A Common Stock)
0.98
2019-09-19
4
J
0
51654
0
A
2024-02-21
Class A Common Stock
51654.0
51654
D
Stock Option (right to buy Class B Common Stock)
1.38
2019-09-19
4
J
0
72916
0
D
2025-02-18
Class B Common Stock
72916.0
0
D
Stock Option (right to buy Class A Common Stock)
1.38
2019-09-19
4
J
0
72916
0
A
2025-02-18
Class A Common Stock
72916.0
72916
D
Stock Option (right to buy Class B Common Stock)
3.73
2019-09-19
4
J
0
800000
0
D
2027-03-16
Class B Common Stock
800000.0
0
D
Stock Option (right to buy Class A Common Stock)
3.73
2019-09-19
4
J
0
800000
0
A
2027-03-16
Class A Common Stock
800000.0
800000
D
Stock Option (right to buy Class B Common Stock)
9.53
2019-09-19
4
J
0
250000
0
D
2028-03-05
Class B Common Stock
250000.0
0
D
Stock Option (right to buy Class A Common Stock)
9.53
2019-09-19
4
J
0
250000
0
A
2028-03-05
Class A Common Stock
250000.0
250000
D
Does not represent a sale or purchase of the issuer's common stock but the automatic conversion of shares of the issuer's Class B Common Stock into shares of the issuer's Class A Common Stock effective as of the date that the total number of shares of outstanding Class B Common Stock ceased to represent at least 15% of all outstanding shares of the issuer's common stock, as set forth in the issuer's Amended and Restated Articles of Incorporation.
These securities are held of record by Douglas Porter, Trustee of each of the T77A Trust and the T49C Trust, trusts for the benefit of the reporting person's children. The reporting person disclaims beneficial ownership over such securities, 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.
In connection with the automatic conversion described in note (1) above, outstanding Class B Common Stock options that were issued under the issuer's 2005 Option/Restricted Stock Plan and 2015 Equity Incentive Plan remain unchanged except that the underlying shares are now Class A Common Stock.
The option is fully vested and exercisable.
The option vested as to 25% of the total shares on February 1, 2018 and then 2.0833% of the total shares vest monthly thereafter, with 100% of the total shares vested and exercisable on February 1, 2021, subject to the reporting person's provision of service to the issuer on each vesting date.
The option vests as 25% of the total shares on February 1, 2019 and then 2.0833% of the total shares vest monthly thereafter, with 100% of the total shares vested and exercisable on February 1, 2022, subject to the reporting person's provision of service to the issuer on each vesting date.
/s/ Paul Porrini as attorney-in-fact for Mark Mader
2019-09-23