0001716837-19-000107.txt : 20190607 0001716837-19-000107.hdr.sgml : 20190607 20190607165126 ACCESSION NUMBER: 0001716837-19-000107 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190605 FILED AS OF DATE: 20190607 DATE AS OF CHANGE: 20190607 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Henricks Alan S. CENTRAL INDEX KEY: 0001513957 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38211 FILM NUMBER: 19886579 MAIL ADDRESS: STREET 1: MODEL N, INC. STREET 2: 777 MARINERS ISLAND BLVD., SUITE 300 CITY: SAN MATEO STATE: CA ZIP: 94404 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ROKU, INC CENTRAL INDEX KEY: 0001428439 STANDARD INDUSTRIAL CLASSIFICATION: CABLE & OTHER PAY TELEVISION SERVICES [4841] IRS NUMBER: 262087865 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 150 WINCHESTER CIRCLE CITY: LOS GATOS STATE: CA ZIP: 95032 BUSINESS PHONE: 408-446-1459 MAIL ADDRESS: STREET 1: 150 WINCHESTER CIRCLE CITY: LOS GATOS STATE: CA ZIP: 95032 FORMER COMPANY: FORMER CONFORMED NAME: ROKU INC DATE OF NAME CHANGE: 20080228 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2019-06-05 0001428439 ROKU, INC ROKU 0001513957 Henricks Alan S. C/O ROKU, INC. 150 WINCHESTER CIRCLE LOS GATOS CA 95032 1 0 0 0 Class A Common Stock 2019-06-05 4 C 0 6000 2.28 A 11222 D Class A Common Stock 2019-06-05 4 S 0 6000 100.00 D 5222 D Stock Option (right to buy) 2.28 2019-06-05 4 M 0 6000 2.28 D 2022-05-01 Class B Common Stock 6000 105200 D Class B Common Stock 2.28 2019-06-05 4 M 0 6000 2.28 A 2022-05-01 Class A Common Stock 6000 6000 D Class B Common Stock 2.28 2019-06-05 4 C 0 6000 2.28 D 2022-05-01 Class A Common Stock 6000 0 D Shares sold pursuant to Mr. Henrick's 10b5-1 plan dated November 13, 2018. 1/48 of the Option vests in equal monthly installments one month from 5/1/2012. Each share of Class B Common Stock is convertible at any time at the option of the Reporting Person into one share of Class A Common Stock and has no expiration date. Shares of Class B Common Stock will convert automatically into shares of Class A Common Stock upon the earlier of: (i) any transfer except for certain "Permitted Transfers" as defined in the Issuer's restated certificate of incorporation, (ii) the first "Trading Day", as defined in the Issuer's restated certificate of incorporation, falling on or after the date on which the shares of Class B Common Stock represent less than 10% of the aggregate number of outstanding shares of Class A Common Stock and Class B Common Stock or (iii) the vote of the holders of Class B Common Stock representing at least 66-2/3% of the shares of Class B Common Stock. /s/ Stephen Kay, attorney-in-fact 2019-06-07