0000899243-16-030231.txt : 20160928
0000899243-16-030231.hdr.sgml : 20160928
20160928163018
ACCESSION NUMBER: 0000899243-16-030231
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160928
FILED AS OF DATE: 20160928
DATE AS OF CHANGE: 20160928
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Shintaffer Kurt
CENTRAL INDEX KEY: 0001685074
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37885
FILM NUMBER: 161907266
MAIL ADDRESS:
STREET 1: 11100 NE 8TH ST #600
CITY: BELLEVUE
STATE: WA
ZIP: 98004
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-09-28
0
0001419625
Apptio Inc
APTI
0001685074
Shintaffer Kurt
11100 NE 8TH STREET, SUITE 600
BELLEVUE
WA
98004
0
1
0
0
Chief Financial Officer
Series A Preferred Stock
2016-09-28
4
C
0
14573
0.00
D
Class B Common Stock
14573
0
D
Series B Preferred Stock
2016-09-28
4
C
0
11042
0.00
D
Class B Common Stock
11042
0
D
Class B Common Stock
2016-09-28
4
C
0
25615
0.00
A
Class A Common Stock
25615
957877
D
The Preferred Stock automatically converted into the issuer's Class B Common Stock on a 1-for-1 basis immediately prior to the closing of the issuer's initial public offering and had no expiration date.
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.
This total does not include the 87,738 shares held by KCS 2012 GRAT, the 87,738 shares held by KDS 2012 GRAT, or the 12,262 shares held by the Reporting Person's spouse.
/s/ John Morrow, attorney-in-fact
2016-09-28