Forescout Form 4 / Rami Kalish ownership change

SEC Form 4

FORM 4

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
or Section 30(h) of the Investment Company Act of 1940

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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).

1. Name and Address of Reporting Person^*

Kalish Rami

(Last)

(First)

(Middle)

11 HAMENOFIM STREET, BUILDING B

(Street)

HERZELIYA

46725

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
FORESCOUT TECHNOLOGIES, INC [ FSCT ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	X	10% Owner
	Officer (give title below)		Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
10/31/2017

4. If Amendment, Date of Original Filed (Month/Day/Year)

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 (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	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)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Stock	10/31/2017		C		200,927	A	⁽¹⁾	2,727,332	I	See footnote⁽²⁾
Common Stock	10/31/2017		C		18,574	A	⁽¹⁾	252,110	I	See footnote⁽³⁾
Common Stock	10/31/2017		C		54,330	A	⁽¹⁾	737,464	I	See footnote⁽⁴⁾
Common Stock	10/31/2017		C		7,072	A	⁽¹⁾	95,998	I	See footnote⁽⁵⁾
Common Stock	10/31/2017		C		29,235	A	⁽¹⁾	374,768	I	See footnote⁽⁶⁾
Common Stock	10/31/2017		C		14,145	A	⁽¹⁾	191,953	I	See footnote⁽⁷⁾⁽⁸⁾

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 (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	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 (Month/Day/Year)		7. Title and Amount of Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Series F Convertible Preferred Stock	⁽¹⁾	10/31/2017		A			200,927	⁽¹⁾	⁽¹⁾	Common Stock	200,927	$0	0	I	See footnote
Series F Convertible Preferred Stock	⁽¹⁾	10/31/2017		A			18,574	⁽¹⁾	⁽¹⁾	Common Stock	18,574	$0	0	I	See footnote
Series F Convertible Preferred Stock	⁽¹⁾	10/31/2017		A			54,330	⁽¹⁾	⁽¹⁾	Common Stock	54,330	$0	0	I	See footnote
Series F Convertible Preferred Stock	⁽¹⁾	10/31/2017		A			7,072	⁽¹⁾	⁽¹⁾	Common Stock	7,072	$0	0	I	See footnote
Series F Convertible Preferred Stock	⁽¹⁾	10/31/2017		A			29,235	⁽¹⁾	⁽¹⁾	Common Stock	29,235	$0	0	I	See footnote
Series F Convertible Preferred Stock	⁽¹⁾	10/31/2017		A			14,145	⁽¹⁾	⁽¹⁾	Common Stock	14,145	$0	0	I	See footnote

Explanation of Responses:

1. The Series F Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.

2. The shares are held of record by Pitango Venture Capital Fund III (USA) L.P. ("Fund III USA"). Pitango V.C. Fund III General Partner ("Pitango GP"), the general partner of Fund III USA, has sole voting and dispositive power with respect to the shares held by Fund III USA. The reporting person shares voting and dispositive power with respect to the shares held by Pitango GP and disclaims beneficial ownership of the securities held by Fund III USA except to the extent of any pecuniary interest therein.

3. The shares are held of record by Pitango Venture Capital Fund III (USA) Non-Q L.P. ("Fund III USA Non-Q"). Pitango GP, the general partner of Fund III USA Non-Q, has sole voting and dispositive power with respect to the shares held by Fund III USA Non-Q. The reporting person shares voting and dispositive power with respect to the shares held by Pitango GP and disclaims beneficial ownership of the securities held by Fund III USA Non-Q except to the extent of any pecuniary interest therein.

4. The shares are held of record by Pitango Venture Capital Fund III (Israeli Investors) L.P. ("Fund III Israeli Investors"). Pitango GP, the general partner of Fund III Israeli Investors, has sole voting and dispositive power with respect to the shares held by Fund III Israeli Investors. The reporting person shares voting and dispositive power with respect to the shares held by Pitango GP and disclaims beneficial ownership of the securities held by Fund III Israeli Investors except to the extent of any pecuniary interest therein.

5. The shares are held of record by Pitango Principals Fund III (USA) L.P. ("Principals Fund III"). Pitango GP, the general partner of Principals Fund III, has sole voting and dispositive power with respect to the shares held by Principals Fund III. The reporting person shares voting and dispositive power with respect to the shares held by Pitango GP and disclaims beneficial ownership of the securities held by Principals Fund III except to the extent of any pecuniary interest therein.

6. The shares are held of record by Pitango Parallel Investor Fund III (USA) L.P ("Parallel Investor Fund"). Pitango GP, the general partner of Parallel Investor Fund, has sole voting and dispositive power with respect to the shares held by Parallel Investor Fund. The reporting person shares voting and dispositive power with respect to the shares held by Pitango GP and disclaims beneficial ownership of the securities held by Parallel Investor Fund except to the extent of any pecuniary interest therein.

7. The shares are held of record by Pitango Venture Capital Fund III Trusts 2000 Ltd ("Capital Fund 2000"). Capital Fund 2000 is owned and controlled indirectly by the Principals which holds shares of the Issuer in trust for three limited partnerships: Pitango CEO Fund III (USA) L.P., Pitango CEO Fund III (Israel) L.P. and Pitango Family Fund III (Israel) L.P. These three limited partnerships are managed by their sole general partner, the GP.

8. Pitango GP, the general partner of Parallel Investor Fund, has sole voting and dispositive power with respect to the shares held by Capital Fund 2000. The partners of Pitango GP are eight private companies that are each owned by one of the Principals, share voting and dispositive power with respect to the shares held by Capital Fund 2000. The reporting person shares voting and dispositive power with respect to the shares held by Pitango GP and disclaims beneficial ownership of the securities held by Capital Fund 2000 except to the extent of any pecuniary interest therein.

Remarks:

This report on Form 4 is the second of two reports relating to the same transaction.

	/s/ Rami Kalish	11/02/2017
	** Signature of Reporting Person	Date
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.

Forescout (FSCT) Form 4FORESCOUT / Rami Kalish ownership change