FORM 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
Form 3 Holdings Reported. | |||||||||||||||||
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Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
ForgeRock, Inc. [ FORG ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended
(Month/Day/Year) 12/31/2021 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||||||
Amount | (A) or (D) | Price | |||||||||||||
Class A Common Stock | 11/29/2021 | C4(1) | 3,954,737 | A | $0.00 | 3,954,737 | I | See Footnote(2)(3) | |||||||
Class A Common Stock | 11/29/2021 | C4(1) | 97,663 | A | $0.00 | 97,663 | I | See Footnote(3)(4) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | ||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
Class B Common Stock | $0.00 | 11/29/2021 | 4C(1) | 3,954,737 | (1) | (1) | Class A Common Stock | 3,954,737 | $0.00 | 0 | I | See Footnote(2)(3) | ||
Class B Common Stock | $0.00 | 11/29/2021 | 4C(1) | 97,663 | (1) | (1) | Class A Common Stock | 97,663 | $0.00 | 0 | I | See Footnote(3)(4) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. Each share of Class B Common Stock, par value $0.001 per share (the "Class B Common Stock") of ForgeRock, Inc. (the "Issuer") is convertible at any time at the option of the holder into one share of the Issuer's Class A Common Stock, par value $0.001 per share (the "Class A Common Stock"). Additionally, each share of Class B Common Stock will, subject to certain conditions and exceptions, convert automatically into one share of Class A Common Stock upon any transfer. |
2. Shares are held by Meritech Capital Partners IV L.P. ("MCP IV"). Meritech Capital Associates IV L.L.C. ("GP IV"), the general partner of MCP IV, has sole voting and dispositive power with respect to the shares held by MCP IV. Paul Madera ("Madera"), George Bischof ("Bischof"), Craig Sherman ("Sherman") and Rob Ward ("Ward"), the managing members of GP IV, share the voting and dispositive power with respect to the shares held by MCP IV. |
3. Each of the Reporting Persons disclaims the existence of a "group" and disclaims beneficial ownership of the securities reported herein, except to the extent of such Reporting Person's pecuniary interest therein. The filing of this statement shall not be deemed to be an admission that, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the Reporting Persons are the beneficial owners of any securities reported herein. |
4. Shares are held by Meritech Capital Affiliates IV L.P. ("MCA IV"). GP IV, the general partner of MCA IV, has sole voting and dispositive power with respect to the shares held by MCA IV. Madera, Bischof, Sherman and Ward, the managing members of GP IV, share the voting and dispositive power with respect to the shares held by MCA IV. |
Remarks: |
Meritech Capital Associates IV L.L.C., /s/ Joel Backman, Attorney-in-Fact | 02/14/2022 | |
Meritech Capital Partners IV L.P., by Meritech Capital Associates IV L.L.C., its general partner, /s/ Joel Backman, Attorney-in-Fact | 02/14/2022 | |
Meritech Capital Affiliates IV L.P., by Meritech Capital Associates IV L.L.C., its general partner, /s/ Joel Backman, Attorney-in-Fact | 02/14/2022 | |
Craig Sherman, /s/ Joel Backman, Attorney-in-Fact | 02/14/2022 | |
Rob Ward, /s/ Joel Backman, Attorney-in-Fact | 02/14/2022 | |
George Bischof, /s/ Joel Backman, Attorney-in-Fact | 02/14/2022 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |