0000899243-18-017221.txt : 20180619 0000899243-18-017221.hdr.sgml : 20180619 20180619183626 ACCESSION NUMBER: 0000899243-18-017221 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180124 FILED AS OF DATE: 20180619 DATE AS OF CHANGE: 20180619 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Stoner Chelsea R. CENTRAL INDEX KEY: 0001741527 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38525 FILM NUMBER: 18908245 MAIL ADDRESS: STREET 1: C/O AVALARA, INC. STREET 2: 255 SOUTH KING ST., SUITE 1800 CITY: SEATTLE STATE: WA ZIP: 98104 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AVALARA INC CENTRAL INDEX KEY: 0001348036 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 911995935 STATE OF INCORPORATION: WA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1100 2ND AVENUE STREET 2: SUITE 300 CITY: SEATTLE STATE: WA ZIP: 98101 BUSINESS PHONE: (206) 641-2560 MAIL ADDRESS: STREET 1: 1100 2ND AVENUE STREET 2: SUITE 300 CITY: SEATTLE STATE: WA ZIP: 98101 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2018-01-24 0 0001348036 AVALARA INC AVLR 0001741527 Stoner Chelsea R. 255 SOUTH KING ST., SUITE 1800 SEATTLE WA 98104 1 0 0 0 Common Stock 2018-06-19 4 M 0 10000 4.50 A 10000 D Common Stock 2018-06-19 4 F 0 1011 44.525 D 8989 D Common Stock 2018-06-19 4 M 0 10000 9.72 A 18989 D Common Stock 2018-06-19 4 F 0 2184 44.525 D 16805 D Common Stock 2018-06-19 4 M 0 10000 12.20 A 26805 D Common Stock 2018-06-19 4 F 0 2741 44.525 D 24064 D Common Stock 2018-06-19 4 M 0 10000 12.60 A 34064 D Common Stock 2018-06-19 4 F 0 2830 44.525 D 31234 D Common Stock 2018-06-19 4 M 0 10000 13.84 A 41234 D Common Stock 2018-06-19 4 F 0 3109 44.525 D 38125 D Common Stock 2018-06-19 4 M 0 10000 16.60 A 48125 D Common Stock 2018-06-19 4 F 0 3729 44.525 D 44396 D Warrant (right to buy) 16.60 2018-01-24 4 A 0 10000 0.00 A Common Stock 10000 10000 D Warrant (right to buy) 4.50 2018-06-19 4 M 0 10000 0.00 D Common Stock 10000 0 D Warrant (right to buy) 9.72 2018-06-19 4 M 0 10000 0.00 D Common Stock 10000 0 D Warrant (right to buy) 12.20 2018-06-19 4 M 0 10000 0.00 D Common Stock 10000 0 D Warrant (right to buy) 12.60 2018-06-19 4 M 0 10000 0.00 D Common Stock 10000 0 D Warrant (right to buy) 13.84 2018-06-19 4 M 0 10000 0.00 D Common Stock 10000 0 D Warrant (right to buy) 16.60 2018-06-19 4 M 0 10000 0.00 D Common Stock 10000 0 D The shares issuable upon exercise of the warrant are subject to the terms of a lock-up agreement entered into in connection with the Issuer's initial public offering. The warrant was fully exercisable upon grant. Unless sooner exercised, the warrant expires immediately prior to the closing of the Issuer's initial public offering and will be automatically net exercised pursuant to its terms if not exercised prior to that time. /s/ Daniel E. Manning, Attorney-in-Fact 2018-06-19