0001209191-15-025359.txt : 20150311 0001209191-15-025359.hdr.sgml : 20150311 20150311190141 ACCESSION NUMBER: 0001209191-15-025359 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150311 FILED AS OF DATE: 20150311 DATE AS OF CHANGE: 20150311 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MaxPoint Interactive, Inc. CENTRAL INDEX KEY: 0001611231 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-ADVERTISING [7310] IRS NUMBER: 205530657 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3020 CARRINGTON MILL BLVD. STREET 2: SUITE 300 CITY: MORRISVILLE STATE: NC ZIP: 27560 BUSINESS PHONE: 800-916-9960 MAIL ADDRESS: STREET 1: 3020 CARRINGTON MILL BLVD. STREET 2: SUITE 300 CITY: MORRISVILLE STATE: NC ZIP: 27560 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jordan Len CENTRAL INDEX KEY: 0001582456 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36864 FILM NUMBER: 15694029 MAIL ADDRESS: STREET 1: C/O CONTROL4 CORPORATION STREET 2: 11734 S. ELECTION ROAD CITY: SALT LAKE CITY STATE: UT ZIP: 84020 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2015-03-11 0 0001611231 MaxPoint Interactive, Inc. MXPT 0001582456 Jordan Len 999 THIRD AVE. 34TH FLOOR SEATTLE WA 98104 1 0 1 0 Common Stock 2015-03-11 4 C 0 4393356 A 4393356 I By Madrona Venture Fund IV, L.P. Common Stock 2015-03-11 4 C 0 111970 A 111970 I By Madrona Venture Fund IV-A, L.P. Series C Preferred Stock 2015-03-11 4 C 0 3690493 0.00 D Common Stock 3690493 0 I By Madrona Venture Fund IV, L.P. Series C Preferred Stock 2015-03-11 4 C 0 94057 0.00 D Common Stock 94057 0 I By Madrona Venture Fund IV-A, L.P. Series D Preferred Stock 2015-03-11 4 C 0 702863 0.00 D Common Stock 702863 0 I By Madrona Venture Fund IV, L.P. Series D Preferred Stock 2015-03-11 4 C 0 17913 0.00 D Common Stock 17913 0 I By Madrona Venture Fund IV-A, L.P. Each share of convertible preferred stock automatically converted into one (1) share of Common Stock in connection with the consummation of Issuer's initial public offering and had no expiration date. Shares held directly by Madrona Venture Fund IV, L.P. ("Madrona Fund IV"). The Reporting Person is a managing director of Madrona IV General Partner, LLC, the general partner of Madrona Investment Partners IV, L.P., itself the general partner of Madrona Venture Fund IV and Madrona Venture Fund IV A, L.P. ("Madrona Fund IV A", and together with "Madrona Fund IV", the "Madrona Venture Funds"), and has shared voting and dispositive power with regard to the shares directly held by the Madrona Venture Funds. Mr. Jordan disclaims beneficial ownership of the securities except to the extent of his pecuniary interest therein. The Reporting Person serves as the representative of the Madrona Venture Funds on the Issuer's board of directors. Shares held directly by Madrona Venture Fund IV-A. The Reporting Person is a managing director of Madrona IV General Partner, LLC, the general partner of Madrona Investment Partners IV, L.P., itself the general partner of Madrona Venture Fund IV and Madrona Venture Fund IV-A, and has shared voting and dispositive power with regard to the shares directly held by the Madrona Venture Funds. Mr. Jordan disclaims beneficial ownership of the securities except to the extent of his pecuniary interest therein. The Reporting Person serves as the representative of the Madrona Venture Funds on the Issuer's board of directors. /s/ Meaghan S. Nelson, Attorney-in-fact 2015-03-11