0001209191-17-039156.txt : 20170612 0001209191-17-039156.hdr.sgml : 20170612 20170612162144 ACCESSION NUMBER: 0001209191-17-039156 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170612 FILED AS OF DATE: 20170612 DATE AS OF CHANGE: 20170612 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SHOTSPOTTER, INC CENTRAL INDEX KEY: 0001351636 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7979 GATEWAY BLVD., STE. 210 CITY: NEWARK STATE: CA ZIP: 94560 BUSINESS PHONE: (510) 794-3100 MAIL ADDRESS: STREET 1: 7979 GATEWAY BLVD., STE. 210 CITY: NEWARK STATE: CA ZIP: 94560 FORMER COMPANY: FORMER CONFORMED NAME: SHOTSPOTTER INC DATE OF NAME CHANGE: 20110517 FORMER COMPANY: FORMER CONFORMED NAME: Shotspotter Inc DATE OF NAME CHANGE: 20060131 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Levensohn Pascal CENTRAL INDEX KEY: 0001394300 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38107 FILM NUMBER: 17906535 MAIL ADDRESS: STREET 1: C/O LEVENSOHN VENTURE PARTNERS STREET 2: 260 TOWNSEND STREET, SUITE 600 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-06-12 0 0001351636 SHOTSPOTTER, INC SSTI 0001394300 Levensohn Pascal 1971 VALLEJO STREET SAINT HELENA CA 94574 1 0 0 0 Common Stock 2017-06-12 4 C 0 271 0.00 A 673 D Common Stock 2017-06-12 4 C 0 458 0.00 A 1131 D Common Stock 2017-06-12 4 C 0 11694 0.00 A 28995 I By Trust Common Stock 2017-06-12 4 C 0 13764 0.00 A 42759 I By Trust Common Stock 2017-06-12 4 C 0 1123 0.00 A 1977 I By Trust Common Stock 2017-06-12 4 C 0 10110 0.00 A 12087 I By Trust Common Stock 2017-06-12 4 C 0 1600 0.00 A 3982 I By Limited Liability Company Common Stock 2017-06-12 4 C 0 2473 0.00 A 6455 I By Limited Liability Company Series A-2 Preferred Stock 2017-06-12 4 C 0 380 D Common Stock 271 0 D Series B-1 Preferred Stock 2017-06-12 4 C 0 458 D Common Stock 458 0 D Warrant (Right to Buy) 2017-06-12 4 C 0 48 A 2019-08-31 Common Stock 48 48 D Series A-2 Preferred Stock 2017-06-12 4 C 0 16343 D Common Stock 11694 0 I By Trust Series B-1 Preferred Stock 2017-06-12 4 C 0 13764 D Common Stock 13764 0 I By Trust Warrant (Right to Buy) 2017-06-12 4 C 0 1800 A 2019-08-31 Common Stock 1800 1800 I By Trust Series A-2 Preferred Stock 2017-06-12 4 C 0 1570 D Common Stock 1123 0 I By Trust Series B-1 Preferred Stock 2017-06-12 4 C 0 10110 D Common Stock 10110 0 I By Trust Warrant (Right to Buy) 2017-06-12 4 C 0 785 A 2019-08-31 Common Stock 785 785 I By Trust Series A-2 Preferred Stock 2017-06-12 4 C 0 2237 D Common Stock 1600 0 I By Limited Liability Company Series B-1 Preferred Stock 2017-06-12 4 C 0 2473 D Common Stock 2473 0 I By Limited Liability Company Warrant (Right to Buy) 2017-06-12 4 C 0 262 D 2019-07-12 Common Stock 262 262 I By Limited Liability Company Shares are held directly by Pascal Levensohn Revocable Trust, over which Reporting Person holds voting and dispositive power. Shares are held directly by Levensohn 2000 Children's Trust, over which Reporting Person holds voting and dispositive power. Shares are held directly by Levensohn Securities Holdings, LLC, over which Reporting Person holds voting and dispositive power. Each share of Series A-2 Preferred Stock automatically converted into 0.715548 shares of Common Stock upon the closing of the Issuer's initial public offering of Common Stock and has no expiration date. Inapplicable. Each share of Series B-1 Preferred Stock automatically converted into 1 share of Common Stock upon the closing of the Issuer's initial public offering of Common Stock and has no expiration date. Right has converted from right to buy Series B-1 Preferred Stock to right to buy Common Stock. Immediate. /s/ Pascal Levensohn 2017-06-12