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