0000899243-16-030235.txt : 20160928 0000899243-16-030235.hdr.sgml : 20160928 20160928163105 ACCESSION NUMBER: 0000899243-16-030235 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: Gupta Sachin CENTRAL INDEX KEY: 0001685044 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37885 FILM NUMBER: 161907281 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 0001685044 Gupta Sachin 11100 NE 8TH STREET, SUITE 600 BELLEVUE WA 98004 1 1 1 0 See Remarks Series A Preferred Stock 2016-09-28 4 C 0 36429 0.00 D Class B Common Stock 36429 0 D Series B Preferred Stock 2016-09-28 4 C 0 18404 0.00 D Class B Common Stock 18404 0 D Class B Common Stock 2016-09-28 4 C 0 54833 0.00 A Class A Common Stock 54833 3844833 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 1,500,000 shares held by PG GRAT of 2016. President and Chief Executive Officer /s/ John Morrow, attorney-in-fact 2016-09-28