0001209191-15-056511.txt : 20150625 0001209191-15-056511.hdr.sgml : 20150625 20150625184353 ACCESSION NUMBER: 0001209191-15-056511 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150625 FILED AS OF DATE: 20150625 DATE AS OF CHANGE: 20150625 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Xactly Corp CENTRAL INDEX KEY: 0001322554 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 113744289 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 300 PARK AVENUE, SUITE 1700 CITY: SAN JOSE STATE: CA ZIP: 95110 BUSINESS PHONE: (408) 977-3132 MAIL ADDRESS: STREET 1: 300 PARK AVENUE, SUITE 1700 CITY: SAN JOSE STATE: CA ZIP: 95110 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Di Bona Tony CENTRAL INDEX KEY: 0001316825 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37451 FILM NUMBER: 15952851 MAIL ADDRESS: STREET 1: 400 HAMILTON AVENUE STREET 2: 4TH FLOOR CITY: PALO ALTO STATE: CA ZIP: 94301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hanafi Ammar CENTRAL INDEX KEY: 0001316968 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37451 FILM NUMBER: 15952852 MAIL ADDRESS: STREET 1: 400 HAMILTON AVENUE STREET 2: 4TH FLOOR CITY: PALO ALTO STATE: CA ZIP: 94301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hunkapiller Michael CENTRAL INDEX KEY: 0001317102 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37451 FILM NUMBER: 15952853 MAIL ADDRESS: STREET 1: 400 HAMILTON AVENUE STREET 2: 4TH FLOOR CITY: PALO ALTO STATE: CA ZIP: 94301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rubin Daniel CENTRAL INDEX KEY: 0001316624 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37451 FILM NUMBER: 15952854 MAIL ADDRESS: STREET 1: 480 COWPER ST. STREET 2: 2ND FL. CITY: PALO ALTO STATE: CA ZIP: 94301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KELLY DOUGLAS E CENTRAL INDEX KEY: 0001227887 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37451 FILM NUMBER: 15952855 MAIL ADDRESS: STREET 1: 400 HAMILTON AVENUE STREET 2: 4TH FLOOR CITY: PALO ALTO STATE: CA ZIP: 94301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TAYLOR CRAIG C CENTRAL INDEX KEY: 0000939105 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37451 FILM NUMBER: 15952856 MAIL ADDRESS: STREET 1: 400 HAMILTON AVE. STREET 2: 4TH FLOOR CITY: PALO ALTO STATE: CA ZIP: 94301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ALLOY VENTURES 2005 LP CENTRAL INDEX KEY: 0001333202 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37451 FILM NUMBER: 15952857 BUSINESS ADDRESS: STREET 1: 400 HAMILTON AVENUE STREET 2: 4TH FLOOR CITY: PALO ALTO STATE: CA ZIP: 94301 BUSINESS PHONE: 6506875000 MAIL ADDRESS: STREET 1: 400 HAMILTON AVENUE STREET 2: 4TH FLOOR CITY: PALO ALTO STATE: CA ZIP: 94301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Alloy Ventures 2005, LLC CENTRAL INDEX KEY: 0001355724 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37451 FILM NUMBER: 15952858 BUSINESS ADDRESS: STREET 1: 400 HAMILTON AVENUE, 4TH FLOOR CITY: PALO ALTO STATE: CA ZIP: 94301 BUSINESS PHONE: (650) 687-5000 MAIL ADDRESS: STREET 1: 400 HAMILTON AVENUE, 4TH FLOOR CITY: PALO ALTO STATE: CA ZIP: 94301 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2015-06-25 0 0001322554 Xactly Corp XTLY 0001355724 Alloy Ventures 2005, LLC 400 HAMILTON AVENUE, 4TH FLOOR PALO ALTO CA 94301 0 0 1 0 0001333202 ALLOY VENTURES 2005 LP 400 HAMILTON AVENUE, 4TH FLOOR PALO ALTO CA 94301 0 0 1 0 0000939105 TAYLOR CRAIG C 400 HAMILTON AVENUE, 4TH FLOOR PALO ALTO CA 94301 0 0 1 0 0001227887 KELLY DOUGLAS E 400 HAMILTON AVENUE, 4TH FLOOR PALO ALTO CA 94301 0 0 1 0 0001316624 Rubin Daniel 400 HAMILTON AVENUE, 4TH FLOOR PALO ALTO CA 94301 0 0 1 0 0001317102 Hunkapiller Michael 400 HAMILTON AVENUE, 4TH FLOOR PALO ALTO CA 94301 0 0 1 0 0001316968 Hanafi Ammar 400 HAMILTON AVENUE, 4TH FLOOR PALO ALTO CA 94301 0 0 1 0 0001316825 Di Bona Tony 400 HAMILTON AVENUE, 4TH FLOOR PALO ALTO CA 94301 0 0 1 0 Series A Convertible Preferred Stock Common Stock 5398 I See footnote Series B Convertible Preferred Stock Common Stock 2858 I See footnote Series C Convertible Preferred Stock Common Stock 1772524 I See footnote Series D Convertible Preferred Stock Common Stock 460281 I See footnote Series D-1 Convertible Preferred Stock Common Stock 105168 I See footnote Series F Convertible Preferred Stock Common Stock 40693 I See footnote Series F Convertible Preferred Stock Warrant (right to buy) 9.83 Series F Convertible Preferred Stock 10173 I See footnote The Series A Convertible Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of common stock and has no expiration date. All shares are held of record by Alloy Ventures 2005, L.P. ("Alloy Ventures 2005"). Craig C. Taylor, Douglas E. Kelly, John F. Shoch, Tony Di Bona, Daniel Rubin, Michael W. Hunkapiller and Ammar H. Hanafi are the managing members of Alloy Ventures 2005, LLC, the general partner of Alloy Ventures 2005, and share voting and dispositive power over the shares held by Alloy Ventures 2005. Each of the Reporting Persons disclaims beneficial ownership of these shares except to the extent of any pecuniary interest therein, and the filing of this report is not an admission that any Reporting Person is the beneficial owner of these shares for purposes of Section 16 or for any other purpose. The Series B Convertible Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of common stock and has no expiration date. The Series C Convertible Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of common stock and has no expiration date. The Series D Convertible Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of common stock and has no expiration date. The Series D-1 Convertible Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of common stock and has no expiration date. The Series F Convertible Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of common stock and has no expiration date. The Series F Convertible Preferred Stock Warrant is immediately exercisable and expires upon completion of the Issuer's initial public offering of common stock. /s/ Tony Di Bona, managing member of Alloy Ventures 2005, LLC 2015-06-25 /s/ Tony Di Bona, managing member of Alloy Ventures 2005, LLC, the general partner of Alloy Ventures 2005, L.P. 2015-06-25 /s/ Tony Di Bona by power of attorney for Craig C. Taylor 2015-06-25 /s/ Tony Di Bona by power of attorney for Douglas E. Kelly 2015-06-25 /s/ Tony Di Bona by power of attorney for John F. Shoch 2015-06-25 /s/ Tony Di Bona by power of attorney for Daniel Rubin 2015-06-25 /s/ Tony Di Bona by power of attorney for Michael W. Hunkapiller 2015-06-25 /s/ Tony Di Bona by power of attorney for Ammar H. Hanafi 2015-06-25 /s/ Tony Di Bona 2015-06-25