0000899243-20-014642.txt : 20200529 0000899243-20-014642.hdr.sgml : 20200529 20200529212904 ACCESSION NUMBER: 0000899243-20-014642 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200529 FILED AS OF DATE: 20200529 DATE AS OF CHANGE: 20200529 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Pressman Amy E CENTRAL INDEX KEY: 0001782198 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38982 FILM NUMBER: 20930744 MAIL ADDRESS: STREET 1: C/O MEDALLIA INC STREET 2: 575 MARKET STREET SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hald Borge CENTRAL INDEX KEY: 0001782199 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38982 FILM NUMBER: 20930745 MAIL ADDRESS: STREET 1: C/O MEDALLIA INC STREET 2: 575 MARKET STREET SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 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 2020-05-29 0 0001540184 Medallia, Inc. MDLA 0001782199 Hald Borge C/O MEDALLIA, INC. 575 MARKET STREET, SUITE 1850 SAN FRANCISCO CA 94105 1 0 0 0 0001782198 Pressman Amy E C/O MEDALLIA, INC. 575 MARKET STREET, SUITE 1850 SAN FRANCISCO CA 94105 1 0 0 0 Common Stock 2020-05-29 4 A 0 6541 0.00 A 3087823 I See footnote Common Stock 2989255 D Common Stock 1865289 I See footnote Common Stock 1615289 I See footnote Common Stock 165734 I See footnote Common Stock 90734 I See footnote Common Stock 77973 I See footnote Common Stock 1500000 I See footnote The reported shares are represented by restricted stock units, or RSUs, which vest on the earlier of (i) May 29, 2021 or (ii) the day prior to the date of the Issuer's next annual meeting of stockholders. The shares are held of record by Ms. Pressman. The reporting persons are husband and wife. The shares are held of record by the Borge Hald Irrevocable Trust U/A/D 11/4/2019 First Republic Trust Company of Delaware LLC, Trustee for which Mr. Hald serves as an investment advisor. The shares are held of record by the Amy Hald Irrevocable Trust U/A/D 11/4/2019 First Republic Trust Company of Delaware LLC, Trustee for which Ms. Pressman serves as an investment advisor. The shares are held of record by the Borge Hald Irrevocable Trust II U/A/D 11/4/2019 First Republic Trust Company of Delaware LLC, Trustee for which Mr. Hald serves as an investment advisor. The shares are held of record by the Amy Hald Irrevocable Trust II U/A/D 11/4/2019 First Republic Trust Company of Delaware LLC, Trustee for which Ms. Pressman serves as an investment advisor. The shares are held of record by the Amy Hald Irrevocable Trust III U/A/D 11/4/2019 First Republic Trust Company of Delaware LLC, Trustee for which Ms. Pressman serves as an investment advisor. The shares are held of record by the Hald 2011 Irrevocable Children's Trust dtd 8/4/2011 First Republic Trust Company of Delaware LLC, Trustee for which Mr. Hald and Ms. Pressman serve as investment advisors. /s/ Roxanne Oulman, by power of attorney for Borge Hald 2020-05-29 /s/ Roxanne Oulman, by power of attorney for Amy Pressman 2020-05-29