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