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 |
| |||||||||||||||
| 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*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol QLIK TECHNOLOGIES INC [ QLIK ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| ||||||||||||||||||||||||
| 3. Date of Earliest Transaction (Month/Day/Year) 06/05/2015 | ||||||||||||||||||||||||||
| 4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
| |||||||||||||||||||||||||
| 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) | |||
| Code | V | Amount | (A) or (D) | Price | ||||||
| Common Stock | 06/06/2015 | M | 6,625 | A | (1) | 11,583 | D | |||
| Common Stock | 06/07/2015 | M | 2,275 | A | (1) | 13,858 | D | |||
| Common Stock | 06/07/2015 | M | 2,025 | A | (1) | 15,883 | D | |||
| Common Stock | 06/08/2015 | M | 14,025 | A | $22.68 | 29,908 | D | |||
| Common Stock | 06/08/2015 | M | 4,425 | A | $22.26 | 34,333 | D | |||
| Common Stock | 06/08/2015 | S(2) | 4,917 | D | $36.4493(3) | 29,416 | D | |||
| Common Stock | 06/08/2015 | S(4) | 23,058 | D | $36.8071(5) | 6,358 | 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 (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) | ||||
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
| Employee Stock Option (Right to Buy) | $37.32 | 06/05/2015 | A | 37,300 | (6) | 06/05/2025 | Common Stock | 37,300 | $0.00 | 37,300 | D | ||||
| Restricted Stock Unit | (1) | 06/05/2015 | A | 16,100 | (7) | (8) | Common Stock | 16,100 | $0.00 | 16,100 | D | ||||
| Restricted Stock Unit | (1) | 06/06/2015 | M | 6,625 | (9) | (8) | Common Stock | 6,625 | $0.00 | 19,875 | D | ||||
| Restricted Stock Unit | (1) | 06/07/2015 | M | 2,275 | (10) | (8) | Common Stock | 2,275 | $0.00 | 4,550 | D | ||||
| Restricted Stock Unit | (1) | 06/07/2015 | M | 2,025 | (11) | (8) | Common Stock | 2,025 | $0.00 | 2,025 | D | ||||
| Employee Stock Option (Right to Buy) | $22.68 | 06/08/2015 | M | 14,025 | (12) | 06/06/2024 | Common Stock | 14,025 | $0.00 | 42,075 | D | ||||
| Employee Stock Option (Right to Buy) | $22.26 | 06/08/2015 | M | 4,425 | (13) | 06/07/2022 | Common Stock | 4,425 | $0.00 | 17,700 | D | ||||
| Explanation of Responses: |
| 1. Each restricted stock unit ("RSU") represents a contingent right to receive one share of the Issuer's common stock. |
| 2. Represents shares of the Issuer's common stock sold to satisfy tax obligations relating to the acquisition of shares of the Issuer's common stock in connection with the vesting of RSUs described in this Form 4. |
| 3. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $36.33 to $36.50, inclusive. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer or the staff of the Securities Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnotes (3) and (5) to this Form 4. |
| 4. The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the Reporting Person on September 15, 2011, as amended. |
| 5. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $36.36 to $37.13, inclusive. |
| 6. Exercisable with respect to one quarter (1/4) of the shares of stock which are subject to this option on June 5, 2016 (the "Initial Vesting Date"), provided Reporting Person remains continuously employed by the Issuer through the Initial Vesting Date; and exercisable with respect to three quarters (3/4) of the shares of stock which are subject to this option in equal increments quarterly over three (3) years beginning on the date three (3) months from the Initial Vesting Date, provided that the Reporting Person remains continuously employed by the Issuer through the last day of each quarterly period. |
| 7. The RSUs vest in four equal annual installments beginning June 5, 2016, provided that the Reporting Person remains continuously employed by the Issuer through each applicable vesting date. The vested shares will be delivered to the Reporting Person upon vesting. |
| 8. Not applicable. |
| 9. The RSUs vest in four (4) equal annual installments beginning June 6, 2015, provided that the Reporting Person remains continuously employed by the Issuer through each applicable vesting date. The vested shares will be delivered to the Reporting Person upon vesting. |
| 10. The RSUs vest in four (4) equal annual installments beginning June 7, 2014, provided that the Reporting Person remains continuously employed by the Issuer through each applicable vesting date. The vested shares will be delivered to the Reporting Person upon vesting. |
| 11. The RSUs vest in four (4) equal annual installments beginning June 7, 2013, provided that the Reporting Person remains continuously employed by the Issuer through each applicable vesting date. The vested shares will be delivered to the Reporting Person upon vesting. |
| 12. Exercisable with respect to one quarter (1/4) of the shares of stock which are subject to this option on June 6, 2015 (the "Initial Vesting Date"), provided Reporting Person remains continuously employed by the Issuer through the Initial Vesting Date; and exercisable with respect to three quarters (3/4) of the shares of stock which are subject to this option in equal increments quarterly over three (3) years beginning on the date three (3) months from the Initial Vesting Date, provided that the Reporting Person remains continuously employed by the Issuer through the last day of each quarterly period. |
| 13. Exercisable with respect to one-quarter (1/4) of the shares of stock which are subject to this option on June 7, 2013 (the "Initial Vesting Date"), provided Reporting Person remains continuously employed by the Issuer through the Initial Vesting Date; and exercisable with respect to three-quarters (3/4) of the shares of stock which are subject to this option in equal increments quarterly over three (3) years beginning on the date three (3) months from the Initial Vesting Date, provided that the Reporting Person remains continuously employed by the Issuer through the last day of each quarterly period. |
| Remarks: |
| /s/ Deborah C. Lofton, Attorney-in-Fact for Anthony Deighton | 06/09/2015 | |
| ** 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. | ||