0000899243-18-026604.txt : 20181011 0000899243-18-026604.hdr.sgml : 20181011 20181011194811 ACCESSION NUMBER: 0000899243-18-026604 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20181011 FILED AS OF DATE: 20181011 DATE AS OF CHANGE: 20181011 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kaveripatnam Sandesh CENTRAL INDEX KEY: 0001753516 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38698 FILM NUMBER: 181119147 MAIL ADDRESS: STREET 1: 50 HAWTHORNE STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94107 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Anaplan, Inc. CENTRAL INDEX KEY: 0001540755 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 270897861 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 50 HAWTHORNE STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: 415-742-8199 MAIL ADDRESS: STREET 1: 50 HAWTHORNE STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94105 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2018-10-11 0 0001540755 Anaplan, Inc. PLAN 0001753516 Kaveripatnam Sandesh C/O ANAPLAN, INC. 50 HAWTHORNE STREET SAN FRANCISCO CA 94105 1 0 0 0 Common Stock 158499 D Common Stock 1320287 I By Napean Trading and Investment Company (Singapore) Pte. LTD Series A Convertible Preferred Stock Common Stock 35806 D Series A Convertible Preferred Stock Common Stock 327168 I By Napean Trading and Investment Company (Singapore) Pte. LTD Series E Convertible Preferred Stock Common Stock 3861730 I By Napean Trading and Investment Company (Singapore) Pte. LTD Series F Convertible Preferred Stock Common Stock 2272727 I By Napean Trading and Investment Company (Singapore) Pte. LTD Napean Trading and Investment Co (Singapore) Pte. Ltd. is an entity affiliated with Premji Invest. Sandesh Kaveripatnam is a member of our board of directors and is a partner of Napean Trading and Investment Co (Singapore) Pte. Ltd and as such Mr. Kaveripatnam may be deemed to have voting and investment power with respect to such shares. Mr. Kaveripatnam disclaims beneficial ownership of the shares held by the aforementioned entity except to the extent of any pecuniary interest therein. The reported security is convertible into the Issuer's Common Stock on a 1-for-1 basis at any time at the holder's election and shall automatically convert into Common Stock immediately prior to the closing of the Issuer's initial public offering without payment of further consideration. The shares have no expiration date. /s/ Suhani Akare, Attorney-in-Fact 2018-10-11 EX-24 2 attachment1.htm EX-24 DOCUMENT
                         Anaplan, Inc. - Power of Attorney

     KNOW ALL BY THESE PRESENTS, the undersigned hereby constitutes and appoints
each of Gary Spiegel and Suhani Akhare, signing singly, and with full power of
substitution, the undersigned's true and lawful attorney-in-fact to:

 (1) execute for and on behalf of the undersigned a Form ID Application, if
     required, and submit the same to the United States Securities and Exchange
     Commission;

 (2) execute for and on behalf of the undersigned, in the undersigned's capacity
     as an officer and/or director of Anaplan, Inc. (the "Company") or as a
     holder of 10% or more of the Company's securities, Forms 3, 4 and 5, and
     any amendments thereto, in accordance with Section 16 of the Securities
     Exchange Act of 1934, as amended, and the rules thereunder and, if
     necessary, such forms or similar reports required by state or foreign
     regulators in jurisdictions in which the Company operates;

 (3) do and perform any and all acts for and on behalf of the undersigned that
     may be necessary or desirable to complete and execute any such Form 3, 4 or
     5 or similar form or report required by state or foreign regulators, and
     any amendments thereto, and file such form or report with the United States
     Securities and Exchange Commission and any stock exchange or similar
     authority or appropriate state or foreign regulator; and

 (4) take any other action of any type whatsoever in connection with the
     foregoing that, in the opinion of such attorney-in-fact, may be of benefit
     to, in the best interest of or legally required to be done by the
     undersigned, it being understood that the documents executed by such
     attorney-in-fact on behalf of the undersigned pursuant to this Power of
     Attorney shall be in such form and shall contain such terms and conditions
     as such attorney-in- fact may approve in such attorney-in-fact's
     discretion.

     The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that such attorney-in-fact, or such
attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be
done by virtue of this Power of Attorney and the rights and powers herein
granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in
serving in such capacity at the request of the undersigned, are not assuming,
nor is the Company assuming, any of the undersigned's responsibilities to comply
with Section 16 of the Securities Exchange Act of 1934, as amended, and the
rules thereunder. This Power of Attorney may be filed with the SEC as a
confirming statement of the authority granted herein.

     This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4 and 5 with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.

     IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of the date written below.

Date: September 12, 2018
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By:   K.S. Sandesh
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Name: Sandesh Kaveripatnam
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