0001140361-17-004438.txt : 20170203 0001140361-17-004438.hdr.sgml : 20170203 20170203210456 ACCESSION NUMBER: 0001140361-17-004438 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20170201 FILED AS OF DATE: 20170203 DATE AS OF CHANGE: 20170203 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEALTHEQUITY INC CENTRAL INDEX KEY: 0001428336 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 15 WEST SCENIC POINTE DRIVE STREET 2: SUITE 100 CITY: DRAPER STATE: UT ZIP: 84020 BUSINESS PHONE: 801-727-1000 MAIL ADDRESS: STREET 1: 15 WEST SCENIC POINTE DRIVE STREET 2: SUITE 100 CITY: DRAPER STATE: UT ZIP: 84020 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dilsaver Evelyn S CENTRAL INDEX KEY: 0001391387 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36568 FILM NUMBER: 17573930 MAIL ADDRESS: STREET 1: C/O LONGS DRUG STORES CORPORATION STREET 2: 141 NORTH CIVIC DRIVE CITY: WALNUT CREEK STATE: CA ZIP: 94596 4 1 doc1.xml FORM 4 X0306 4 2017-02-01 0 0001428336 HEALTHEQUITY INC HQY 0001391387 Dilsaver Evelyn S C/O HEALTHEQUITY, INC. 15 W. SCENIC POINTE DR., STE. 100 DRAPER UT 84020 1 0 0 0 Restricted Stock Units 2017-02-01 4 A 0 3556 0 A Common Stock 3556 3556 D Stock Option (right to buy) 21.27 2016-02-01 Common Stock 15000 15000 D Stock Option (right to buy) 25.39 2025-03-26 Common Stock 15000 15000 D Stock Option (right to buy) 14 2024-07-30 Common Stock 7500 7500 D Stock Option (right to buy) 14 2024-07-30 Common Stock 25000 25000 D Each restricted stock unit represents a contingent right to receive one share of the issuer's common stock. The restricted stock units will vest as to 1,778 shares on the date of the issuer's annual stockholder meeting, if any, held in the current fiscal year; the remainder will vest on January 31, 2018. Vested shares will be delivered to the reporting person upon vesting, unless such vesting does not occur during an "open window period," in which case the shares will be delivered promptly following the first day of the next "open window period." The option is immediately exercisable. The option became exercisable as to 6,250 shares on June 30, 2015 and as to 6,250 shares on June 30, 2016. The option becomes exercisable as to the remaining 12,500 shares in two equal installments of 6,250 shares on June 30, 2017 and 2018. Exhibit List: Exhibit 24 - Power of Attorney /s/ DELANO W. LADD, attorney-in-fact 2017-02-03 EX-24 2 d19760151.htm POWER OF ATTORNEY
 
LIMITED POWER OF ATTORNEY FOR SECTION 16 REPORTING OBLIGATIONS
Know all by these presents, that the undersigned hereby constitutes and appoints each of Delano W. Ladd, Darcy G. Mott and Willkie Farr & Gallagher LLP, or any of them acting singly and with full power of substitution, the undersigned's true and lawful attorney-in-fact to:
1.
execute for and on behalf of the undersigned, in the undersigned's capacity as an officer or director or both of HealthEquity, Inc. (the "Company"), Forms 3, 4 and 5 (and any amendments thereto) in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), and the rules thereunder;
2.
do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4 or 5, complete and execute any amendments thereto, and timely file such form with the U.S. Securities and Exchange Commission (the "SEC") and any securities exchange or similar authority, including without limitation the filing of a Form ID or any other documents necessary or appropriate to enable the undersigned to file the Forms 3, 4 and 5 electronically with the SEC;
3.
seek or obtain, as the undersigned's representative and on the undersigned's behalf, information on transactions in the Company's securities from any third party, including brokers, employee benefit plan administrators and trustees, and the undersigned hereby authorizes any such person to release any such information to each of the undersigned's attorneys-in-fact appointed by this Limited Power of Attorney and approves and ratifies any such release of information; and
4.
take any other action in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by or for, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Limited Power of Attorney shall be in such form and shall contain such information and disclosure as such attorney-in-fact may approve in such attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever required, necessary or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this Limited Power of Attorney and the rights and powers herein granted.
The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request and on the behalf of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with, or any liability for the failure to comply with, any provision of Section 16 of the Exchange Act.
 
This Limited Power of Attorney revokes any earlier Limited Power of Attorney delivered to the Company by the undersigned relating to the matters contemplated herein and shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 or 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to each of the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has executed this Limited Power of Attorney as of this 1st day of December, 2016.
 
Signed and acknowledged:
   
   
 
/s/ Evelyn Dilsaver                               
 
Signature
   
   
 
Evelyn Dilsaver                                   
 
Printed Name