FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Xactly Corp [ XTLY ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 07/01/2015 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 07/01/2015 | C | 1,860,236 | A | (1)(2)(3)(4)(5) | 1,860,236 | I | See footnote(7) | ||
Common Stock | 07/01/2015 | C | 1,129,524 | A | (1)(2)(3)(4)(5)(6) | 1,129,524 | I | See footnote(8) | ||
Common Stock | 07/01/2015 | C | 3,394 | A | (1)(2)(3)(4)(5)(6) | 3,394 | I | See footnote(9) | ||
Common Stock | 07/01/2015 | C | 101,733 | A | (6) | 101,733 | I | See footnote(10) | ||
Common Stock | 07/01/2015 | P | 375,000 | A | $8 | 375,000 | I | See footnote(11) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series A Convertible Preferred Stock | (1) | 07/01/2015 | C | 938,323 | (1) | (1) | Common Stock | 938,323 | $0.00 | 0 | I | See footnote(7) | |||
Series A Convertible Preferred Stock | (1) | 07/01/2015 | C | 5,894 | (1) | (1) | Common Stock | 5,894 | $0.00 | 0 | I | See footnote(8) | |||
Series A Convertible Preferred Stock | (1) | 07/01/2015 | C | 17 | (1) | (1) | Common Stock | 17 | $0.00 | 0 | I | See footnote(9) | |||
Series B Convertible Preferred Stock | (2) | 07/01/2015 | C | 370,325 | (2) | (2) | Common Stock | 370,325 | $0.00 | 0 | I | See footnote(7) | |||
Series B Convertible Preferred Stock | (2) | 07/01/2015 | C | 72,589 | (2) | (2) | Common Stock | 72,589 | $0.00 | 0 | I | See footnote(8) | |||
Series B Convertible Preferred Stock | (2) | 07/01/2015 | C | 217 | (2) | (2) | Common Stock | 217 | $0.00 | 0 | I | See footnote(9) | |||
Series C Convertible Preferred Stock | (3) | 07/01/2015 | C | 209,761 | (3) | (3) | Common Stock | 209,761 | $0.00 | 0 | I | See footnote(7) | |||
Series C Convertible Preferred Stock | (3) | 07/01/2015 | C | 130,990 | (3) | (3) | Common Stock | 130,990 | $0.00 | 0 | I | See footnote(8) | |||
Series C Convertible Preferred Stock | (3) | 07/01/2015 | C | 393 | (3) | (3) | Common Stock | 393 | $0.00 | 0 | I | See footnote(9) | |||
Series D Convertible Preferred Stock | (4) | 07/01/2015 | C | 295,919 | (4) | (4) | Common Stock | 295,919 | $0.00 | 0 | I | See footnote(7) | |||
Series D Convertible Preferred Stock | (4) | 07/01/2015 | C | 603,313 | (4) | (4) | Common Stock | 603,313 | $0.00 | 0 | I | See footnote(8) | |||
Series D Convertible Preferred Stock | (4) | 07/01/2015 | C | 1,815 | (4) | (4) | Common Stock | 1,815 | $0.00 | 0 | I | See footnote(9) | |||
Series D-1 Convertible Preferred Stock | (5) | 07/01/2015 | C | 45,908 | (5) | (5) | Common Stock | 45,908 | $0.00 | 0 | I | See footnote(7) | |||
Series D-1 Convertible Preferred Stock | (5) | 07/01/2015 | C | 93,596 | (5) | (5) | Common Stock | 93,596 | $0.00 | 0 | I | See footnote(8) | |||
Series D-1 Convertible Preferred Stock | (5) | 07/01/2015 | C | 281 | (5) | (5) | Common Stock | 281 | $0.00 | 0 | I | See footnote(9) | |||
Series F Convertible Preferred Stock | (6) | 07/01/2015 | C | 223,142 | (6) | (6) | Common Stock | 223,142 | $0.00 | 0 | I | See footnote(8) | |||
Series F Convertible Preferred Stock | (6) | 07/01/2015 | C | 671 | (6) | (6) | Common Stock | 671 | $0.00 | 0 | I | See footnote(9) | |||
Series F Convertible Preferred Stock | (6) | 07/01/2015 | C | 101,733 | (6) | (6) | Common Stock | 101,733 | $0.00 | 0 | I | See footnote(10) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. The Series A Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of common stock and had no expiration date. |
2. The Series B Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of common stock and had no expiration date. |
3. The Series C Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of common stock and had no expiration date. |
4. The Series D Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of common stock and had no expiration date. |
5. The Series D-1 Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of common stock and had no expiration date. |
6. The Series F Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of common stock and had no expiration date. |
7. The reported securities are held of record by Rembrandt Venture Partners II, L.P. (RVP II). Gerald S. Casilli, a director of the Issuer, and Douglas Schrier, as the managing members of Rembrandt Venture Partners II LLC, the general partner of RVP II, share voting and dispositive power with respect to the shares held by RVP II. Messrs. Casilli and Schrier disclaim beneficial ownership of the securities reported herein, except to the extent of any individual pecuniary interest therein. |
8. The reported securities are held of record by Rembrandt Venture Partners Fund Two, L.P. (RVPF 2). Messrs. Casilli and Schrier and Scott Irwin, as the managing members of Rembrandt Venture Partners Fund Two, LLC, the general partner of RVPF 2, share voting and dispositive power with respect to the shares held by RVPF 2. Messrs. Casilli, Schrier and Irwin disclaim beneficial ownership of the securities reported herein, except to the extent of any individual pecuniary interest therein. |
9. The reported securities are held of record by Rembrandt Venture Partners Fund Two-A, L.P. (RVPF 2-A). Messrs. Casilli, Schrier and Irwin, as the managing members of Rembrandt Venture Partners Fund Two, LLC, the general partner of RVPF 2-A, share voting and dispositive power with respect to the shares held by RVPF 2-A. Messrs. Casilli, Schrier and Irwin disclaim beneficial ownership of the securities reported herein, except to the extent of any individual pecuniary interest therein. |
10. The reported securities are held of record by Rembrandt Venture Partners Opportunities Fund I, L.P. (RVP Opportunities I). Messrs. Casilli, Schrier and Irwin, as the managing members of Rembrandt Venture Partners Opportunities GP I, LLC, the general partner of RVP Opportunities I, share voting and dispositive power with respect to the shares held by RVP Opportunities I. Messrs. Casilli, Schrier and Irwin disclaim beneficial ownership of the securities reported herein, except to the extent of any individual pecuniary interest therein. |
11. The reported securities are held of record by RVP Opportunities Fund II, L.P. (RVP Opportunities II). Messrs. Casilli, Schrier and Irwin, as the managing members of RVP Opportunities GP II, LLC, the general partner of RVP Opportunities II, share voting and dispositive power with respect to the shares held by RVP Opportunities II. Messrs. Casilli, Schrier and Irwin disclaim beneficial ownership of the securities reported herein, except to the extent of any individual pecuniary interest therein. |
Remarks: |
/s/ Gerald S. Casilli, a managing member of Rembrandt Venture Partners II LLC | 07/01/2015 | |
/s/ Gerald S. Casilli, a managing member of Rembrandt Venture Partners II LLC, the general partner of Rembrandt Venture Partners II, L.P. | 07/01/2015 | |
/s/ Gerald S. Casilli, a managing member of Rembrandt Venture Partners Fund Two, LLC | 07/01/2015 | |
/s/ Gerald S. Casilli, a managing member of Rembrandt Venture Partners Fund Two, LLC, the general partner of Rembrandt Venture Partners Fund Two, L.P. | 07/01/2015 | |
/s/ Gerald S. Casilli, a managing member of Rembrandt Venture Partners Fund Two, LLC, the general partner of Rembrandt Venture Partners Fund Two-A, L.P. | 07/01/2015 | |
/s/ Gerald S. Casilli, a managing member of Rembrandt Venture Partners Opportunities GP I, LLC | 07/01/2015 | |
/s/ Gerald S. Casilli, a managing member of Rembrandt Venture Partners Opportunities GP I, LLC, the general partner of Rembrandt Venture Partners Opportunities Fund I, L.P. | 07/01/2015 | |
/s/ Gerald S. Casilli, a managing member of RVP Opportunities GP II, LLC | 07/01/2015 | |
/s/ Gerald S. Casilli, a managing member of RVP Opportunities GP II, LLC, the general partner of RVP Opportunities Fund II, L.P. | 07/01/2015 | |
** 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 4 (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. |