0001366561-19-000053.txt : 20190618 0001366561-19-000053.hdr.sgml : 20190618 20190618205740 ACCESSION NUMBER: 0001366561-19-000053 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190614 FILED AS OF DATE: 20190618 DATE AS OF CHANGE: 20190618 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gomez Elena CENTRAL INDEX KEY: 0001674159 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38464 FILM NUMBER: 19904904 MAIL ADDRESS: STREET 1: C/O ZENDESK, INC. STREET 2: 1019 MARKET STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94103 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SMARTSHEET INC CENTRAL INDEX KEY: 0001366561 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 202954357 STATE OF INCORPORATION: WA FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 10500 NE 8TH STREET STREET 2: SUITE 1300 CITY: BELLEVUE STATE: WA ZIP: 98004 BUSINESS PHONE: 855-420-2395 MAIL ADDRESS: STREET 1: 10500 NE 8TH STREET STREET 2: SUITE 1300 CITY: BELLEVUE STATE: WA ZIP: 98004 FORMER COMPANY: FORMER CONFORMED NAME: SMARTSHEET.COM INC DATE OF NAME CHANGE: 20060619 4 1 wf-form4_156090584482556.xml FORM 4 X0306 4 2019-06-14 0 0001366561 SMARTSHEET INC SMAR 0001674159 Gomez Elena C/O SMARTSHEET INC. 10500 NE 8TH ST., SUITE 1300 BELLEVUE WA 98004 1 0 0 0 Class A Common Stock 2019-06-14 4 C 0 2500 0 A 2500 I By Juan L. Gomez and Elena C. Gomez Declaration of Trust Class A Common Stock 2019-06-14 4 S 0 2500 45.76 D 0 I By Juan L. Gomez and Elena C. Gomez Declaration of Trust Class A Common Stock 10000 D Class B Common Stock 2019-06-14 4 C 0 2500 0 D Class A Common Stock 2500.0 20107 I By Juan L. Gomez and Elena C. Gomez Declaration of Trust Represents the number of shares that were acquired upon conversion of Class B Common Stock to Class A Common Stock. These securities are held of record by Juan L. Gomez and Elena C Gomez, Trustees of the Juan L. Gomez and Elena C. Gomez Declaration of Trust Dated April 2, 2009. The sales reported on this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the holder. Each share of the issuer's Class B Common Stock will convert into 1 share of the issuer's Class A Common Stock (a) at the option of the holder or (b) automatically upon (i) any transfer which occurs after the closing of the IPO, except for certain permitted transfers, or (ii) the date that is the earliest of (x) the date specified by a vote of the holders of not less than a majority of the outstanding shares of Class B Common Stock, (y) April 26, 2025 and (z) the date that the total number of shares of outstanding Class B Common Stock ceases to represent at least 15% of all outstanding shares of the issuer's common stock, and has no expiration date. The holder elected to convert the Class B common stock to Class A common stock on a 1-for-1 basis. /s/ Paul Porrini as attorney-in-fact for Elena Gomez 2019-06-18