0001181431-11-055526.txt : 20111109 0001181431-11-055526.hdr.sgml : 20111109 20111109131522 ACCESSION NUMBER: 0001181431-11-055526 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111108 FILED AS OF DATE: 20111109 DATE AS OF CHANGE: 20111109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Slootman Frank CENTRAL INDEX KEY: 0001402348 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35338 FILM NUMBER: 111190692 MAIL ADDRESS: STREET 1: C/O DATA DOMAIN, INC. STREET 2: 2300 CENTRAL EXPRESSWAY CITY: SANTA CLARA STATE: CA ZIP: 95050 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: IMPERVA INC CENTRAL INDEX KEY: 0001364962 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 030460133 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3400 BRIDGE PARKWAY, SUITE 200 CITY: REDWOOD SHORES STATE: CA ZIP: 94065 BUSINESS PHONE: 650-345-9000 MAIL ADDRESS: STREET 1: 3400 BRIDGE PARKWAY, SUITE 200 CITY: REDWOOD SHORES STATE: CA ZIP: 94065 4 1 rrd324566.xml FORM 4 X0304 4 2011-11-08 0 0001364962 IMPERVA INC IMPV 0001402348 Slootman Frank C/O IMPERVA, INC. 3400 BRIDGE PARKWAY, SUITE 200 REDWOOD SHORES CA 94065 1 0 0 0 Common Stock 18.00 2011-11-08 4 A 0 25000 0 A Common Stock 25000 25000 D This common stock was granted under the Issuer's 2011 Stock Option and Incentive Plan on November 8, 2011 and is immediately exercisable. Expires 30 days from the date of grant. /s/ Tram Phi, by power of attorney 2011-11-08