0001381752-19-000021.txt : 20190923 0001381752-19-000021.hdr.sgml : 20190923 20190923195310 ACCESSION NUMBER: 0001381752-19-000021 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190919 FILED AS OF DATE: 20190923 DATE AS OF CHANGE: 20190923 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McIlwain Matthew S CENTRAL INDEX KEY: 0001381752 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38464 FILM NUMBER: 191109019 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: 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_156928277385986.xml FORM 4 X0306 4 2019-09-19 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 2019-09-19 4 C 0 6132030 A 6132030 I By Madrona Venture Fund III, L.P. Class A Common Stock 2019-09-19 4 C 0 244959 A 244959 I By Madrona Venture Fund III-A, L.P. Class A Common Stock 2019-09-19 4 C 0 1282835 A 1282835 I By Madrona Venture Fund IV, L.P. Class A Common Stock 2019-09-19 4 C 0 32692 A 32692 I By Madrona Venture Fund IV-A, L.P. Class A Common Stock 166818 D Class B Common Stock 2019-09-19 4 C 0 6132030 0 D Class A Common Stock 6132030.0 0 I By Madrona Venture Fund III, L.P. Class B Common Stock 2019-09-19 4 C 0 244959 0 D Class A Common Stock 244959.0 0 I By Madrona Venture Fund III-A, L.P. Class B Common Stock 2019-09-19 4 C 0 1282835 0 D Class A Common Stock 1282835.0 0 I By Madrona Venture Fund IV, L.P. Class B Common Stock 2019-09-19 4 C 0 32692 0 D Class A Common Stock 32692.0 0 I By Madrona Venture Fund IV-A, L.P. Does not represent a sale or purchase of the issuer's common stock but the automatic conversion of shares of the issuer's Class B Common Stock into shares of the issuer's Class A Common Stock effective as of the date that the total number of shares of outstanding Class B Common Stock ceased to represent at least 15% of all outstanding shares of the issuer's common stock, as set forth in the issuer's Amended and Restated Articles of Incorporation. These securities are held of record by Madrona Venture Fund III, L.P ("Madrona III") and Madrona Venture Fund III-A, L.P. ("Madrona III-A"), as applicable. Madrona Investment Partners III, L.P. ("Madrona Partners III") is the general partner of Madrona III and Madrona III-A, and Madrona III General Partner, LLC ("Madrona III LLC") is the general partner of Madrona Partners III. Matthew McIlwain, a member of the issuer's board of directors, together with Tom Alberg, Paul Goodrich, Scott Jacobson, Len Jordon, and Tim Porter, are the managing members of Madrona III LLC, and each may be deemed to share voting and investment power over the securities held by Madrona III and Madrona III-A. The reporting person disclaims beneficial ownership over such securities except to the extent of his pecuniary interest therein, and such securities' inclusion herein shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or any other purposes. These securities are held of record by Madrona Venture Fund IV, L.P. ("Madrona IV") and Madrona Venture Fund IV-A, L.P. ("Madrona IV-A"), as applicable. Madrona Investment Partners IV, L.P. ("Madrona Partners IV") is the general partner of Madrona IV and Madrona IV-A, and Madrona IV General Partner, LLC ("Madrona IV LLC") is the general partner of Madrona Partners IV. Matthew McIlwain, a member of the issuer's board of directors, together with Tom Alberg, Paul Goodrich, Scott Jacobson, Len Jordon, and Tim Porter, are the managing members of Madrona IV LLC, and each may be deemed to share voting and investment power over the securities held by Madrona IV and Madrona IV-A. The reporting person disclaims beneficial ownership over such securities except to the extent of his pecuniary interest therein, and such securities' inclusion herein shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or any other purposes. /s/ Paul Porrini as attorney-in-fact for Matthew McIlwain 2019-09-23