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Sec Form 4 Filing - Tomlinson Steffan @ QLIK TECHNOLOGIES INC - 2016-08-22

  1. About Form 4 Filing: Every director, officer or owner of more than ten percent of a class of equity securities registered under Section 12 of the '34 Act must file with the U.S. Securities and Exchange Commission (SEC) a statement of ownership regarding such security. The initial filing is on Form 3 and changes are reported on Form 4. The Annual Statement of beneficial ownership of securities is on Form 5. The forms contain information on the reporting person's relationship to the company and on purchases and sales of such equity securities.
  2. Form 4 is stored in SEC's EDGAR database. EDGAR is Electronic Data Gathering, Analysis and Retrieval System. It is a registered trademark of the SEC.

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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
Washington, D.C. 20549
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
OMB Number: 3235-0287
Expires: November 30, 2011
Estimated average burden hours per response... 0.5
1. Name and Address of Reporting Person *
Tomlinson Steffan
2. Issuer Name and Ticker or Trading Symbol
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
3. Date of Earliest Transaction (MM/DD/YY)
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 08/22/2016 D 7,700 D 0 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) $ 27.21 08/22/2016 D 48,263 ( 2 ) 03/07/2023 Common Stock 48,263 $ 3.29 0 D
Restricted Stock Unit ( 3 ) 08/22/2016 D 6,500 ( 4 ) ( 5 ) Common Stock 6,500 $ 30.5 0 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Tomlinson Steffan
/s/ Deborah C. Lofton, Attorney-in-Fact for Steffan Tomlinson 08/22/2016
** Signature of Reporting Person Date
Explanation of Responses:
( 1 )Disposed of pursuant to the Agreement and Plan of Merger between Issuer, Project Alpha Holding, LLC and Project Alpha Merger Corp. (the "Merger Agreement"), whereby, immediately prior to the effective time of the merger contemplated therein (the "Effective Time"), all issued and outstanding shares of Issuer common stock were converted into the right to receive $30.50 per share in cash and, when so converted, automatically cancelled.
( 2 )This option, which provided for vesting with respect to one-twelfth (1/12) of the shares of stock which are subject to this option in equal increments quarterly over three (3) years beginning April 28, 2013, provided Reporting Person remained continuously employed by the Issuer through the last day of each quarterly period, was cancelled pursuant to the Merger Agreement and, as soon as possible following the Effective Time, the Reporting Person was entitled to receive a cash payment equal to the product of (1) the difference between the exercise price and $30.50 and (2) the number of unexercised options.
( 3 )Each restricted stock unit ("RSU") represented a contingent right to receive one share of the Issuer's common stock.
( 4 )The RSU, which provided for vesting and settlement on May 12, 2017 was cancelled pursuant to the Merger Agreement and the Reporting Person became entitled to receive an initial cash payment equal to the product of $30.50 and the sum of the number of vested but unsettled shares of common stock and 1/3 of the unvested shares of common stock subject to this RSU. The Reporting Person shall be entitled to receive a payment for the remaining 2/3 of the unvested shares of common stock subject to this RSU in equal portions promptly following the 12 and 18 month anniversaries of the Effective Time or upon the earlier date as the RSU was scheduled to vest according to the original vesting conditions, provided the Reporting Person remains continuously employed by the Issuer through such date and provided further that if the Reporting Person is terminated without cause, the vesting conditions will be deemed satisfied on the Reporting Person's last day of employment.
( 5 )Not applicable.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.