0000899243-19-015212.txt : 20190530
0000899243-19-015212.hdr.sgml : 20190530
20190530190017
ACCESSION NUMBER: 0000899243-19-015212
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190528
FILED AS OF DATE: 20190530
DATE AS OF CHANGE: 20190530
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Shasta Ventures II LP
CENTRAL INDEX KEY: 0001418902
STATE OF INCORPORATION: DE
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38698
FILM NUMBER: 19868067
BUSINESS ADDRESS:
STREET 1: c/o Shasta Ventures
STREET 2: 2440 Sand Hill Road, Suite 300
CITY: Menlo Park
STATE: CA
ZIP: 94025
BUSINESS PHONE: (650) 543-1700
MAIL ADDRESS:
STREET 1: c/o Shasta Ventures
STREET 2: 2440 Sand Hill Road, Suite 300
CITY: Menlo Park
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Shasta Ventures II GP, LLC
CENTRAL INDEX KEY: 0001649997
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38698
FILM NUMBER: 19868068
BUSINESS ADDRESS:
STREET 1: 2440 SAND HILL ROAD, SUITE 300
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650 543 1700
MAIL ADDRESS:
STREET 1: 2440 SAND HILL ROAD, SUITE 300
CITY: MENLO PARK
STATE: CA
ZIP: 94025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Anaplan, Inc.
CENTRAL INDEX KEY: 0001540755
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 270897861
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0131
BUSINESS ADDRESS:
STREET 1: 50 HAWTHORNE STREET
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
BUSINESS PHONE: 415-742-8199
MAIL ADDRESS:
STREET 1: 50 HAWTHORNE STREET
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-05-28
1
0001540755
Anaplan, Inc.
PLAN
0001649997
Shasta Ventures II GP, LLC
2440 SAND HILL ROAD, SUITE 300
MENLO PARK
CA
94025
0
0
1
0
0001418902
Shasta Ventures II LP
2440 SAND HILL ROAD, SUITE 300
MENLO PARK
CA
94025
0
0
1
0
Common Stock
2019-05-28
4
J
0
3400000
D
10027098
I
By Shasta Ventures II, L.P.
Common Stock
2019-05-28
4
J
0
707200
A
707200
D
Common Stock
2019-05-28
4
J
0
690200
D
17000
D
Represents a pro rata in kind distribution without consideration by Shasta Ventures II, L.P. ("Shasta II") to its partners, including its general partner, Shasta Ventures II GP, LLC ("Shasta II GP").
These shares are owned directly by Shasta II, of which Shasta II GP is the sole general partner and exercises voting and investment power over these shares. The reporting persons disclaim beneficial ownership of these securities, except to the extent of their respective proportionate pecuniary interest therein and this report shall not be deemed an admission that any reporting person is the beneficial owner of such securities for Section 16 or any other purpose.
Represents the receipt of shares in the pro rata in kind distribution of Common Stock of the Issuer by Shasta II described in footnote (1).
Represents a pro-rata in-kind distribution of shares of Common Stock by Shasta II GP, without consideration, to its members.
Shasta Ventures II GP, LLC, By: /s/ Ravi Mohan, Managing Director
2019-05-30
Shasta Ventures II, L.P., By: Shasta Ventures II GP, LLC, Its: General Partner, By: /s/ Ravi Mohan, Managing Director
2019-05-30