0001200925-23-000006.txt : 20231220
0001200925-23-000006.hdr.sgml : 20231220
20231220192619
ACCESSION NUMBER: 0001200925-23-000006
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231218
FILED AS OF DATE: 20231220
DATE AS OF CHANGE: 20231220
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MADER MARK PATRICK
CENTRAL INDEX KEY: 0001200925
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38464
FILM NUMBER: 231502530
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]
ORGANIZATION NAME: 06 Technology
IRS NUMBER: 202954357
STATE OF INCORPORATION: WA
FISCAL YEAR END: 0131
BUSINESS ADDRESS:
STREET 1: 500 108TH AVE NE
STREET 2: SUITE 200
CITY: BELLEVUE
STATE: WA
ZIP: 98004
BUSINESS PHONE: 844-324-2360
MAIL ADDRESS:
STREET 1: 500 108TH AVE NE
STREET 2: SUITE 200
CITY: BELLEVUE
STATE: WA
ZIP: 98004
FORMER COMPANY:
FORMER CONFORMED NAME: SMARTSHEET.COM INC
DATE OF NAME CHANGE: 20060619
4
1
wk-form4_1703118370.xml
FORM 4
X0508
4
2023-12-18
0
0001366561
SMARTSHEET INC
SMAR
0001200925
MADER MARK PATRICK
C/O SMARTSHEET INC.
500 108TH AVENUE NE #200
BELLEVUE
WA
98004
1
1
0
0
President and CEO
0
Class A Common Stock
2023-12-18
4
G
0
40000
0
D
615759
D
Class A Common Stock
2023-12-18
4
G
0
40000
0
D
575759
D
Class A Common Stock
2023-12-19
4
G
0
10000
0
D
565759
D
Class A Common Stock
2023-12-18
5
G
0
E
40000
0
A
40000
I
By L38 Trust
Class A Common Stock
2023-12-18
5
G
0
E
40000
0
A
40000
I
By L29 Trust
Class A Common Stock
51250
I
By T77A Trust
Class A Common Stock
51250
I
By T49C Trust
Represents shares of the issuer's Class A Common Stock that the reporting person donated as a gift to a donor advised fund.
These securities are held of record by Douglas Porter, Trustee of each of the T77A Trust, T49C Trust, L38 Trust, and L29 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/ Jolene Marshall as attorney-in-fact for Mark Mader
2023-12-20