0001181431-11-055528.txt : 20111109
0001181431-11-055528.hdr.sgml : 20111109
20111109132655
ACCESSION NUMBER: 0001181431-11-055528
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: Shulman Amichai
CENTRAL INDEX KEY: 0001533440
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35338
FILM NUMBER: 111190743
MAIL ADDRESS:
STREET 1: IMPERVA, INC.
STREET 2: 3400 BRIDGE PARKWAY, SUITE 200
CITY: REDWOOD SHORES
STATE: CA
ZIP: 94065
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
rrd324560.xml
FORM 4
X0304
4
2011-11-08
0
0001364962
IMPERVA INC
IMPV
0001533440
Shulman Amichai
C/O IMPERVA, INC.
3400 BRIDGE PARKWAY, SUITE 200
REDWOOD SHORES
CA
94065
0
1
0
0
Chief Technology Officer
Common Stock
2011-11-08
4
S
0
125000
18.00
D
337500
I
See footnote
Common Stock
500000
I
See footnote
The shares are owned of record by Amichai Shulman Assets 2000 Ltd. The Reporting Person is a director and beneficial owner of the shares held by such entity.
The shares are owned of record by Amichai Shulman Holdings 2000 Ltd. The Reporting Person is a director and beneficial owner of the shares held by such entity.
/s/ Tram Phi, by power of attorney
2011-11-08