0000899243-19-001089.txt : 20190111 0000899243-19-001089.hdr.sgml : 20190111 20190111213727 ACCESSION NUMBER: 0000899243-19-001089 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190110 FILED AS OF DATE: 20190111 DATE AS OF CHANGE: 20190111 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SINGH RAJEEV CENTRAL INDEX KEY: 0001219071 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37885 FILM NUMBER: 19523520 MAIL ADDRESS: STREET 1: 6222 185TH AVENUE NE CITY: REDMOND STATE: WA ZIP: 98052 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Apptio Inc CENTRAL INDEX KEY: 0001419625 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 261175252 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 11100 NE 8TH STREET STREET 2: SUITE 600 CITY: BELLEVUE STATE: WA ZIP: 98004 BUSINESS PHONE: 425-453-5861 MAIL ADDRESS: STREET 1: 11100 NE 8TH STREET STREET 2: SUITE 600 CITY: BELLEVUE STATE: WA ZIP: 98004 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-01-10 1 0001419625 Apptio Inc APTI 0001219071 SINGH RAJEEV 11100 NE 8TH STREET, SUITE 600 BELLEVUE WA 98004 1 0 0 0 Class A Common Stock 2019-01-10 4 D 0 13337 D 0 D Stock Option (right to buy) 14.31 2019-01-10 4 D 0 30000 D 2025-11-05 Common Stock 30000 0 D Includes 4,652 RSUs that represent contingent rights to receive 4,652 shares of Issuer's Class A Common stock upon settlement and which vested solely as a result of the consummation of the merger agreement between Apptio, Inc., Bellevue Parent, LLC, and Bellevue Merger Sub, Inc. (the "Merger Agreement"), which were cancelled and automatically converted into the right to receive a cash payment of $38.00 per share. Disposed of pursuant to the Merger Agreement in exchange for a cash payment of $38.00 per share. Includes 7,545 options, which vested solely as a result of the consummation of the merger agreement, which were cancelled and automatically converted into the right to receive a cash payment of $38.00 per share, less the applicable exercise price of the option, subject to any required withholding of taxes. Includes 22,455 vested options were cancelled and automatically converted into the right to receive $38.00 per share, less the applicable per share exercise price and subject to any applicable withholding taxes. 1/3rd of the shares subject to the option became vested on September 29, 2017 and 1/36th of the shares subject to the option shall vest monthly thereafter for the next 24 months. The option is subject to an early exercise right and may be exercised in full prior to the vesting of the shares underlying the option, subject to the issuer's right of repurchase. /s/ John Morrow Attorney-in-Fact for Rajeev Singh 2019-01-11