Sec Form 4 Filing - Ward Rob @ Anaplan, Inc. - 2018-10-16

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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
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1. Name and Address of Reporting Person
Ward Rob
2. Issuer Name and Ticker or Trading Symbol
Anaplan, Inc. [ PLAN]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O MERITECH CAPITAL PARTNERS, 245 LYTTON AVENUE, #125
3. Date of Earliest Transaction (MM/DD/YY)
10/16/2018
(Street)
PALO ALTO, CA94301
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
(City) (State) (Zip)
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 10/16/2018 C 184,427 ( 1 ) A 191,027 I By Meritech Capital Affiliates IV L.P. ( 2 )
Common Stock 10/16/2018 C 7,468,192 ( 1 ) A 7,735,459 I By Meritech Capital Partners IV L.P. ( 2 )
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
(MM/DD/YY)
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
Series A Convertible Preferred Stock ( 3 ) 10/16/2018 C 484 ( 3 ) ( 3 ) Common Stock 484 ( 3 ) 0 I By Meritech Capital Affiliates IV L.P. ( 2 )
Series A Convertible Preferred Stock ( 3 ) 10/16/2018 C 19,604 ( 3 ) ( 3 ) Common Stock 19,604 ( 3 ) 0 I By Meritech Capital Partners IV L.P. ( 2 )
Series C Convertible Preferred Stock ( 3 ) 10/16/2018 C 150,619 ( 3 ) ( 3 ) Common Stock 150,619 ( 3 ) 0 I By Meritech Capital Affiliates IV L.P. ( 2 )
Series C Convertible Preferred Stock ( 3 ) 10/16/2018 C 6,099,119 ( 3 ) ( 3 ) Common Stock 6,099,119 ( 3 ) 0 I By Meritech Capital Partners IV L.P. ( 2 )
Series D Convertible Preferred Stock ( 3 ) 10/16/2018 C 16,854 ( 3 ) ( 3 ) Common Stock 16,854 ( 3 ) 0 I By Meritech Capital Affiliates IV L.P. ( 2 )
Series D Convertible Preferred Stock ( 3 ) 10/16/2018 C 682,520 ( 3 ) ( 3 ) Common Stock 682,520 ( 3 ) 0 I By Meritech Capital Partners IV L.P. ( 2 )
Series E Convertible Preferred Stock ( 3 ) 10/16/2018 C 7,159 ( 3 ) ( 3 ) Common Stock 7,159 ( 3 ) 0 I By Meritech Capital Affiliates IV L.P. ( 2 )
Series E Convertible Preferred Stock ( 3 ) 10/16/2018 C 289,897 ( 3 ) ( 3 ) Common Stock 289,897 ( 3 ) 0 I By Meritech Capital Partners IV L.P. ( 2 )
Series F Convertible Preferred Stock ( 3 ) 10/16/2018 C 9,311 ( 3 ) ( 3 ) Common Stock 9,311 ( 3 ) 0 I By Meritech Capital Affiliates IV L.P. ( 2 )
Series F Convertible Preferred Stock ( 3 ) 10/16/2018 C 377,052 ( 3 ) ( 3 ) Common Stock 377,052 ( 3 ) 0 I By Meritech Capital Partners IV L.P. ( 2 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Ward Rob
C/O MERITECH CAPITAL PARTNERS
245 LYTTON AVENUE, #125
PALO ALTO, CA94301
X
Signatures
/s/ Suhani Akhare, Attorney-in-Fact 10/18/2018
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The total represents shares received upon conversion of shares of Series A Convertible Preferred Stock, Series C Convertible Preferred Stock, Series D Convertible Preferred Stock, Series E Convertible Preferred Stock and Series F Convertible Preferred Stock.
( 2 )Meritech Capital Associates IV L.L.C. is the general partner of Meritech Capital Partners IV L.P. and Meritech Capital Affiliates IV L.P. Robert Ward, a member of our board of directors, is one of several managing members of the general partner of these funds that directly hold shares and as such Mr. Ward may be deemed to have voting and investment power with respect to such shares. Mr. Ward disclaims beneficial ownership of the shares held by the aforementioned entities except to the extent of any pecuniary interest therein.
( 3 )The reported security converted into the Issuer's Common Stock on a 1-for-1 basis automatically immediately prior to the closing of the Issuer's initial public offering without payment of further consideration. The shares have no expiration date.

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