0001200925-21-000024.txt : 20210610 0001200925-21-000024.hdr.sgml : 20210610 20210610201055 ACCESSION NUMBER: 0001200925-21-000024 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210608 FILED AS OF DATE: 20210610 DATE AS OF CHANGE: 20210610 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: 211009629 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_162337023960291.xml FORM 4 X0306 4 2021-06-08 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 2021-06-08 4 S 0 20000 63.02 D 379331 D Class A Common Stock 51250 I By T49C Trust Class A Common Stock 51250 I By T77A Trust 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. /s/ Paul Porrini as attorney-in-fact for Mark Mader 2021-06-10