0001209191-18-019686.txt : 20180314
0001209191-18-019686.hdr.sgml : 20180314
20180314201324
ACCESSION NUMBER: 0001209191-18-019686
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180312
FILED AS OF DATE: 20180314
DATE AS OF CHANGE: 20180314
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: 18690755
MAIL ADDRESS:
STREET 1: 11100 NE 8TH ST #600
CITY: BELLEVUE
STATE: WA
ZIP: 98004
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-03-12
0
0001419625
Apptio Inc
APTI
0001685074
Shintaffer Kurt
11100 NE 8TH STREET, SUITE 600
BELLEVUE
WA
98004
0
1
0
0
Chief Financial Officer
Class A Common Stock
2018-03-12
4
C
0
65858
0.00
A
65858
I
See footnote
Class A Common Stock
2018-03-12
5
G
0
E
65858
0.00
D
0
I
See footnote
Class A Common Stock
2018-03-12
4
C
0
65858
0.00
A
65858
I
See footnote
Class A Common Stock
2018-03-12
5
G
0
E
65858
0.00
D
0
I
See footnote
Class B Common Stock
0.00
2018-03-12
4
C
0
65858
0.00
D
Class A Common Stock
65858
0
I
See footnote
Class B Common Stock
0.00
2018-03-12
4
C
0
65858
0.00
D
Class A Common Stock
65858
0
I
See footnote
Class B Common Stock
0.00
Class A Common Stock
789757
789757
D
Class B Common Stock
0.00
Class A Common Stock
34142
34142
I
See footnote
Represents the conversion of Class B Common Stock into Class A Common Stock held of record.
These shares are held by KCS 2012 GRAT.
Represents a transfer for no consideration to the Trust for Macy Shintaffer established under KCS 2012 GRAT and KDS 2012 GRAT (the "Macy Shintaffer Trust"), as to which Mr. Shintaffer and his spouse disclaim beneficial ownership. Neither Mr. Shintaffer nor his spouse is a beneficiary of the Macy Shintaffer Trust, nor does Mr. Shintaffer or his spouse exercise voting or investment control over such shares. The sole trustee of the Macy Shintaffer Trust, exercises voting and investment control over the shares held of record by the Macy Shintaffer Trust.
These shares are held by KDS 2012 GRAT.
Class B Common Stock is convertible at any time, at the holder's election, into Class A Common Stock on a one-for-one basis and has no expiration date.
Excludes 10,611 shares previously beneficially owned indirectly through the KCS 2012 GRAT which were distributed to the reporting person on March 12, 2018 and are now beneficially owned directly.
Excludes 10,611 shares previously beneficially owned indirectly through the KDS 2012 GRAT which were distributed to the reporting person's spouse on March 12, 2018 and are now beneficially owned directly by the reporting person's spouse.
Includes 10,611 shares previously beneficially owned indirectly through the KCS 2012 GRAT which were distributed to the reporting person on March 12, 2018 and are now beneficially owned directly.
Includes 10,611 shares previously beneficially owned indirectly through the KDS 2012 GRAT which were distributed to the reporting person's spouse on March 12, 2018 and are now beneficially owned directly by the reporting person's spouse.
These shares are held by the Reporting Person's spouse.
/s/ Frederick Williams, attorney-in-fact
2018-03-14