0001366561-23-000003.txt : 20230227 0001366561-23-000003.hdr.sgml : 20230227 20230227170309 ACCESSION NUMBER: 0001366561-23-000003 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221207 FILED AS OF DATE: 20230227 DATE AS OF CHANGE: 20230227 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McIlwain Matthew S CENTRAL INDEX KEY: 0001381752 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38464 FILM NUMBER: 23676337 MAIL ADDRESS: STREET 1: 1000 SECOND AVENUE STREET 2: SUITE 3700 CITY: SEATTLE STATE: WA ZIP: 98104 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: 500 108TH AVE NE STREET 2: SUITE 200 CITY: BELLEVUE STATE: WA ZIP: 98004 BUSINESS PHONE: 844-324-2360 MAIL ADDRESS: STREET 1: 500 108TH AVE NE STREET 2: SUITE 200 CITY: BELLEVUE STATE: WA ZIP: 98004 FORMER COMPANY: FORMER CONFORMED NAME: SMARTSHEET.COM INC DATE OF NAME CHANGE: 20060619 5 1 wf-form5_167753536654726.xml FORM 5 X0306 5 2022-12-07 0 0 0 0001366561 SMARTSHEET INC SMAR 0001381752 McIlwain Matthew S C/O MADRONA VENTURE GROUP 999 THIRD AVE., 34TH FLOOR SEATTLE WA 98104 1 0 0 0 Class A Common Stock 2023-02-27 5 G 0 5500 0 D 128559 D Represents shares of the issuer's Class A Common Stock that the reporting person donated to a Donor Advised Fund. /s/ Jolene Marshall as attorney-in-fact for Matthew McIlwain 2023-02-27