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