SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 04/23/2019 | 3. Issuer Name and Ticker or Trading Symbol SMARTSHEET INC [ SMAR ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
No Securities beneficially held | 0 | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Option (right to buy Class A Common Stock) | (1) | 03/29/2029 | Class A Common Stock | 92,165 | 40.79 | D | |
Restricted Stock Units (RSU) (Class A) | (2) | 03/15/2023 | Class A Common Stock | 49,470 | (3) | D |
Explanation of Responses: |
1. The option vests as to 25% of the total shares on March 15, 2020 and then 6.25% of the total shares vest quarterly thereafter, with 100% of the total shares vested and exercisable on March 15, 2023, subject to the reporting person's provision of service to the issuer on each vesting date. |
2. The RSUs vest as to 25% of the total shares on March 15, 2020 and then 6.25% of the total shares vest quarterly thereafter, with 100% of the total shares vested on March 15, 2023, subject to the reporting person's provision of service to the issuer on each vesting date. |
3. Each RSU represents a contingent right to receive one share of the issuer's Class A Common Stock upon settlement. |
Remarks: |
/s/ Paul Porrini as attorney-in-fact for Anna Griffin | 05/02/2019 | |
** 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 5 (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. |