0001209191-17-062174.txt : 20171121 0001209191-17-062174.hdr.sgml : 20171121 20171121183630 ACCESSION NUMBER: 0001209191-17-062174 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171117 FILED AS OF DATE: 20171121 DATE AS OF CHANGE: 20171121 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: 001-37885 FILM NUMBER: 171218037 MAIL ADDRESS: STREET 1: 1000 SECOND AVENUE STREET 2: SUITE 3700 CITY: SEATTLE STATE: WA ZIP: 98104 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Apptio Inc CENTRAL INDEX KEY: 0001419625 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 261175252 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 11100 NE 8TH STREET STREET 2: SUITE 600 CITY: BELLEVUE STATE: WA ZIP: 98004 BUSINESS PHONE: 425-453-5861 MAIL ADDRESS: STREET 1: 11100 NE 8TH STREET STREET 2: SUITE 600 CITY: BELLEVUE STATE: WA ZIP: 98004 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-11-17 1 0001419625 Apptio Inc APTI 0001381752 McIlwain Matthew S 999 THIRD AVENUE, 34TH FLOOR SEATTLE WA 98104 1 0 1 0 Class A Common Stock 2017-11-17 4 C 0 1150000 0.00 A 1150000 I See footnote Class A Common Stock 2017-11-17 4 J 0 1150000 0.00 D 0 I See footnote Class A Common Stock 2017-11-17 4 J 0 3461 0.00 A 12146 D Class A Common Stock 2017-11-17 4 J 0 1066 0.00 A 1066 I See footnote Class B Common Stock 0.00 2017-11-17 4 C 0 1150000 0.00 D Class A Common Stock 1150000 4049786 I See footnote Includes 1,105,824 shares held by Madrona Venture Fund III, L.P. ("Madrona III") and 44,176 shares held by Madrona Venture Fund III-A, L.P. ("Madrona III-A"). Shares are held by Madrona III and Madrona III-A. Mr. McIlwain is a Managing Director of the various entities affiliated with Madrona. Madrona Investment Partners III, L.P. is the general partner of Madrona III and Madrona III-A. The reporting person disclaims beneficial ownership of the shares except to the extent of his pecuniary interest therein. Represents a pro rata distribution for no consideration to the limited partners and general partners of Madrona III and Madrona III-A (the "Distribution"). Acquisition by the reporting person, who is a Managing Director of the various entities affiliated with Madrona, pursuant to the Distribution. Includes 8,685 RSUs that represent contingent rights to receive 8,685 shares of the Issuer's Class A Common Stock upon settlement. Acquisition by the McIlwain Family GST Trust, pursuant to the Distribution. Class B Common Stock is convertible at any time, at the holder's election, into Class A Common Stock on a 1-for-1 basis and has no expiration date. Includes 3,894,216 shares held by Madrona III and 155,570 shares held Madrona III-A. /s/ Frederick Williams, attorney-in-fact 2017-11-21