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