0001225208-19-012767.txt : 20190923 0001225208-19-012767.hdr.sgml : 20190923 20190923190606 ACCESSION NUMBER: 0001225208-19-012767 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: WHITE JAMES N CENTRAL INDEX KEY: 0001201720 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38464 FILM NUMBER: 191108976 MAIL ADDRESS: STREET 1: 755 PAGE MILL ROAD, SUITE A-200 CITY: PALO ALTO STATE: CA ZIP: 94304-1005 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 doc4.xml X0306 4 2019-09-19 0001366561 SMARTSHEET INC SMAR 0001201720 WHITE JAMES N 755 PAGE MILL ROAD, SUITE A-200 PALO ALTO CA 94304-1005 1 Class A Common Stock 2019-09-19 4 C 0 128509.0000 0.0000 A 236954.0000 I By Ltd Partnership (ROSE) Class A Common Stock 2019-09-19 4 C 0 221602.0000 0.0000 A 272219.0000 I By Trust Class A Common Stock 13519.0000 D Class B Common Stock 2019-09-19 4 C 0 128509.0000 0.0000 D Class A Common Stock 128509.0000 0.0000 I By Ltd Partnership (ROSE) Class B Common Stock 2019-09-19 4 C 0 221602.0000 0.0000 D Class A Common Stock 221602.0000 0.0000 I By Trust 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. Shares held by a limited partnership of which the reporting person is a trustee of a trust which is the general partner. The reporting person disclaims beneficial ownership in these shares except as to the reporting person's pecuniary interest therein. Shares held by a trust of which the reporting person is a trustee. The reporting person disclaims beneficial ownership in these shares except as to the reporting person's pecuniary interest therein. The reporting person shares pecuniary interest in these shares with other individuals pursuant to a contractual relationship. The reporting person disclaims beneficial ownership in these shares except as to the reporting person's pecuniary interest in these shares. /s/ Robert Yin, by power of attorney 2019-09-23