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