0001140361-14-031117.txt : 20140806 0001140361-14-031117.hdr.sgml : 20140806 20140806195042 ACCESSION NUMBER: 0001140361-14-031117 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20140804 FILED AS OF DATE: 20140806 DATE AS OF CHANGE: 20140806 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEALTHEQUITY INC CENTRAL INDEX KEY: 0001428336 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 15 WEST SCENIC POINTE DRIVE STREET 2: SUITE 400 CITY: DRAPER STATE: UT ZIP: 84003 BUSINESS PHONE: 801-727-1000 MAIL ADDRESS: STREET 1: 15 WEST SCENIC POINTE DRIVE STREET 2: SUITE 400 CITY: DRAPER STATE: UT ZIP: 84003 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NEELEMAN DAVID CENTRAL INDEX KEY: 0001218390 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36568 FILM NUMBER: 141021375 4 1 doc1.xml FORM 4 X0306 4 2014-08-04 1 0001428336 HEALTHEQUITY INC HQY 0001218390 NEELEMAN DAVID 819 WEST SADDLEBROOK DRIVE KAYSVILLE UT 84037 0 0 1 0 Common Stock 2014-08-04 4 C 0 2106674 A 2391269 I See footnote Series A Preferred Stock 2014-08-04 4 C 0 918750 0 D Common Stock 918750 0 I See footnote Series B Preferred Stock 2014-08-04 4 C 0 408680 0 D Common Stock 408680 0 I See footnote Series D-1 Preferred Stock 2014-08-04 4 C 0 389622 0 D Common Stock 779244 0 I See footnote The Series A Preferred Stock automatically converted into shares of common stock on a 1-for-1 basis and had no expiration date. The Series B Preferred Stock automatically converted into shares of common stock on a 1-for-1 basis and had no expiration date. The Series D-1 Preferred Stock automatically converted into shares of common stock on a 1-for-2 basis and had no expiration date. Securities are held of record by Neeleman Holdings, L.C. The reporting person is the manager of Neeleman Holdings, L.C. and the reporting person disclaims beneficial ownership in these shares except to the extent of his pecuniary interest in such shares. Exhibit List: Exhibit 24 - Power of Attorney /s/ Frode Jensen, attorney-in-fact 2014-08-06 EX-24 2 poa1.htm POWER OF ATTORNEY

LIMITED POWER OF ATTORNEY FOR SECTION 16 REPORTING OBLIGATIONS
Know all by these presents, that the undersigned hereby constitutes and appoints each of Frode Jensen, Darla Newbold and Willkie Farr & Gallagher LLP, or any of them acting singly and with full power of substitution, the undersigned's true and lawful attorney-in-fact to:
execute for and on behalf of the undersigned, in the undersigned's capacity as an officer or director or both of HealthEquity, Inc. (the "Company"), Forms 3, 4 and 5 (and any amendments thereto) in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), and the rules thereunder;
do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4 or 5, complete and execute any amendments thereto, and timely file such form with the U.S. Securities and Exchange Commission (the "SEC") and any securities exchange or similar authority, including without limitation the filing of a Form ID or any other documents necessary or appropriate to enable the undersigned to file the Forms 3, 4 and 5 electronically with the SEC;
seek or obtain, as the undersigned's representative and on the undersigned's behalf, information on transactions in the Company's securities from any third party, including brokers, employee benefit plan administrators and trustees, and the undersigned hereby authorizes any such person to release any such information to each of the undersigned's attorneys-in-fact appointed by this Limited Power of Attorney and approves and ratifies any such release of information; and
take any other action in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by or for, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Limited Power of Attorney shall be in such form and shall contain such information and disclosure as such attorney-in-fact may approve in such attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever required, necessary or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this Limited Power of Attorney and the rights and powers herein granted.
The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request and on the behalf of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with, or any liability for the failure to comply with, any provision of Section 16 of the Exchange Act.
This Limited Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 or 5 with respect to the undersigned's
 
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holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to each of the foregoing attorneys-in-fact.

IN WITNESS WHEREOF, the undersigned has executed this Limited Power of Attorney as of this 26th day of July, 2014.
 
Signed and acknowledged:
 
 
 
 
 
/s/ David Neeleman                            
 
Signature
 
 
 
 
 
David Neeleman                                
 
Printed Name



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