0000899243-19-020157.txt : 20190723
0000899243-19-020157.hdr.sgml : 20190723
20190723203219
ACCESSION NUMBER: 0000899243-19-020157
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190723
FILED AS OF DATE: 20190723
DATE AS OF CHANGE: 20190723
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Oulman Roxanne
CENTRAL INDEX KEY: 0001523073
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38982
FILM NUMBER: 19969034
MAIL ADDRESS:
STREET 1: 4140 DUBLIN BOULEVARD
STREET 2: SUITE 400
CITY: DUBLIN
STATE: CA
ZIP: 94568
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Medallia, Inc.
CENTRAL INDEX KEY: 0001540184
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0131
BUSINESS ADDRESS:
STREET 1: 575 MARKET STREET
STREET 2: SUITE 1850
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
BUSINESS PHONE: (650) 321-3000
MAIL ADDRESS:
STREET 1: 575 MARKET STREET
STREET 2: SUITE 1850
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
FORMER COMPANY:
FORMER CONFORMED NAME: Medallia Inc.
DATE OF NAME CHANGE: 20120123
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-07-23
0
0001540184
Medallia, Inc.
MDLA
0001523073
Oulman Roxanne
C/O MEDALLIA, INC
575 MARKET STREET, SUITE 1850
SAN FRANCISCO
CA
94105
0
1
0
0
CFO and EVP
Class A Common Stock
2019-07-23
4
J
0
525000
D
0
D
Common Stock
2019-07-23
4
J
0
525000
A
525000
D
Employee Stock Option (right to buy)
6.73
2019-07-23
4
J
0
1000000
D
2028-11-14
Class A Common Stock
1000000
0
D
Employee Stock Option (right to buy)
6.73
2019-07-23
4
J
0
1000000
A
2028-11-14
Common Stock
1000000
1000000
D
Each share of Class A Common Stock was reclassified in an exempt transaction pursuant to Rule 16b-7 into one share of Common Stock immediately prior to the completion of the Issuer's initial public offering of Common Stock.
One-fourth of the shares subject to the option vest on November 5, 2019 and 1/48th vest monthly thereafter.
/s/ Alan K. Grebene, by power of attorney
2019-07-23