SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
CALDWELL NANCI

(Last) (First) (Middle)
C/O TALEND, INC.
800 BRIDGE PARKWAY, SUITE 200

(Street)
REDWOOD CITY CA 94065

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/01/2019
3. Issuer Name and Ticker or Trading Symbol
Talend SA [ TLND ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Ordinary Shares 2,500(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Non-employee Warrant (right to buy) (2) 02/01/2027 Ordinary Shares(1) 5,058 $24.41(3) D
Non-employee Warrant (right to buy) (2) 05/03/2027 Ordinary Shares(1) 7,440 $32.43(4) D
Non-employee Warrant (right to buy) (5) 03/02/2028 Ordinary Shares(1) 9,561 $44.24(6) D
Explanation of Responses:
1. The Ordinary Shares may be represented by American Depositary Shares, each of which currently represents one Ordinary Share.
2. The Ordinary Shares subject to the non-employee warrant are fully vested and immediately exercisable.
3. The exercise price of the non-employee warrant is 21.32 Euros. The U.S. dollar equivalent of the exercise price is $24.41 using the European Central Bank rate as of December 31, 2018 (1.00 = $1.145).
4. The exercise price of the non-employee warrant is 28.32 Euros. The U.S. dollar equivalent of the exercise price is $32.43 using the European Central Bank rate as of December 31, 2018 (1.00 = $1.145).
5. The Ordinary Shares subject to the non-employee warrant vest in four equal quarterly installments beginning on June 2, 2018.
6. The exercise price of the non-employee warrant is 38.64 Euros. The U.S. dollar equivalent of the exercise price is $44.24 using the European Central Bank rate as of December 31, 2018 (1.00 = $1.145).
Remarks:
Exhibit 24 - Power of Attorney
/s/ Aaron Ross, by power of attorney 01/01/2019
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.