0001209191-18-055784.txt : 20181019 0001209191-18-055784.hdr.sgml : 20181019 20181019190206 ACCESSION NUMBER: 0001209191-18-055784 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20180925 FILED AS OF DATE: 20181019 DATE AS OF CHANGE: 20181019 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Patel Dharti CENTRAL INDEX KEY: 0001756182 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38664 FILM NUMBER: 181131334 MAIL ADDRESS: STREET 1: C/O SVMK INC. STREET 2: ONE CURIOSITY WAY CITY: SN MATEO STATE: CA ZIP: 94403 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SVMK Inc. CENTRAL INDEX KEY: 0001739936 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370] IRS NUMBER: 800765058 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE CURIOSITY WAY CITY: SAN MATEO STATE: CA ZIP: 94403 BUSINESS PHONE: 650-543-8400 MAIL ADDRESS: STREET 1: ONE CURIOSITY WAY CITY: SAN MATEO STATE: CA ZIP: 94403 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2018-09-25 0 0001739936 SVMK Inc. SVMK 0001756182 Patel Dharti C/O SVMK INC. ONE CURIOSITY WAY SAN MATEL CA 94403 0 1 0 0 Chief Accounting Officer Common Stock 68042 D Employee Stock Option (Right to buy) 16.03 2025-08-21 Common Stock 50000 D Employee Stock Option (Right to buy) 16.03 2027-02-17 Common Stock 8422 D Employee Stock Option (Right to buy) 13.20 2028-03-05 Common Stock 37431 D Employee Stock Option (Right to buy) 13.65 2028-09-06 Common Stock 24000 D Certain of these securities are restricted stock units. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock, subject to the applicable vesting schedule and conditions. The number of securities beneficially owned is as of October 19, 2018. One-fourth of the shares subject to the option vested on August 21, 2016 and one forty-eighth of the shares subject to the option vest each month thereafter, subject to the Reporting Person continuing as a service provider through each such date. One-twelfth of the shares subject to the option vested on May 15, 2017 and one-twelfth of the shares subject to the option vest each quarter thereafter, subject to the Reporting Person continuing as a service provider through each such date. One-twelfth of the shares subject to the option vested on May 15, 2018 and one-twelfth of the shares subject to the option vest each quarter thereafter, subject to the Reporting Person continuing as a service provider through each such date. One-twelfth of the shares subject to the option vest on November 15, 2018 and one-twelfth of the shares subject to the option vest each quarter thereafter, subject to the Reporting Person continuing as a service provider through each such date. Exhibit 24 - Power of Attorney /s/ Adam M. Inglis, by power of attorney 2018-10-19 EX-24 2 attachment1.htm EX-24 DOCUMENT

       POWER OF ATTORNEY

             The undersigned, as a Section 16 reporting person of SVMK Inc.
       (the "Company"), hereby constitutes and appoints Lora D. Blum, Adam
Inglis, Michael J. McKay, and Lanson Wan,  and each of them, the undersigned's
true and lawful attorney-in-fact, to:
             1.	Prepare, execute in the undersigned's name and on the
undersigned's behalf, and submit to the Securities and Exchange Commission (the
"SEC") a Form ID, including amendments thereto, and any other documents
necessary or appropriate to obtain EDGAR codes and passwords enabling the
undersigned to make electronic filings with the SEC of reports required by
Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation
of the SEC;
             2.	Complete and execute Forms 3, 4 and 5 and other forms and all
amendments thereto as such attorney-in-fact shall in his or her discretion
determine to be required or advisable pursuant to Section 16 of the Securities
Exchange Act of 1934 (as amended) and the rules and regulations promulgated
thereunder, or any successor laws and regulations, as a consequence of the
undersigned's ownership, acquisition or disposition of securities of the
Company; and
             3.	Do all acts necessary in order to file such forms with the SEC,
any securities exchange or national association, the Company and such other
person or agency as the attorney-in-fact shall deem appropriate.
             The undersigned hereby ratifies and confirms all that said
attorneys-in-fact and agent shall do or cause to be done by virtue hereof.  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).
             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 Company and the foregoing attorneys-in-fact.
             IN WITNESS WHEREOF, the undersigned has caused this Power of
Attorney to be executed as of this 12th day of October, 2018.


             					Signature: 	/s/ Dharti Patel
             					Print Name: 	Dharti Patel