| 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) 03/23/2017 | 3. Issuer Name and Ticker or Trading Symbol Alteryx, Inc. [ AYX ] | |||||||||||||
| 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) |
| 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 | ||||
| Class B Common Stock | (1) | (1) | Class A Common Stock | 2,452,343 | (1) | I | See footnote(2) |
| Class B Common Stock | (1) | (1) | Class A Common Stock | 71,423 | (1) | I | See footnote(3) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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| Explanation of Responses: |
| 1. Each share of Class B Common Stock is convertible, at any time at the option of the holder, into one (1) share of Class A Common Stock. In addition, pursuant to the Issuer's Restated Certificate of Incorporation (the "Post-Effective Certificate") that will be effective upon the consummation of the Issuer's initial public offering, each share of Class B Common Stock will convert automatically into one (1) share of Class A Common Stock upon the transfer, whether or not for value, to any transferee who is not a "Permitted Transferee", as defined in the Issuer's Post-Effective Certificate. The shares of Class B Common Stock have no expiration date. |
| 2. Shares are held by Meritech Capital Partners V L.P. ("MCP V"). Meritech Capital Associates V L.L.C. ("GP V"), the general partner of MCP V, has sole voting and dispositive power with respect to the shares held by MCP V. Paul S. Madera, Michael B. Gordon, Robert D. Ward, George H. Bischof and Craig Sherman, the managing members of GP V, share voting and dispositive power with respect to the shares held by MCP V. Such persons and entities disclaim beneficial ownership of the securities held by MCP V except to the extent of any pecuniary interest therein. |
| 3. Shares are held by Meritech Capital Affiliates V L.P. ("MCA V"). Meritech Capital Associates V L.L.C. ("GP V"), the general partner of MCA V, has sole voting and dispositive power with respect to the shares held by MCA V. Paul S. Madera, Michael B. Gordon, Robert D. Ward, George H. Bischof and Craig Sherman, the managing members of GP V, share voting and dispositive power with respect to the shares held by MCA V. Such persons and entities disclaim beneficial ownership of the securities held by MCA V except to the extent of any pecuniary interest therein. |
| Remarks: |
| Meritech Capital Associates V L.L.C. /s/ Joel Backman, Attorney-in-fact | 03/23/2017 | |
| Meritech Capital Partners V L.P., by Meritech Capital Associates V L.L.C., its general partner /s/ Joel Backman, Attorney-in-fact | 03/23/2017 | |
| Meritech Capital Affiliates V L.P., by Meritech Capital Associates V L.L.C., its general partner /s/ Joel Backman, Attorney-in-fact | 03/23/2017 | |
| /s/ Joel Backman, Attorney-in-fact for Craig Sherman | 03/23/2017 | |
| /s/ Joel Backman, Attorney-in-fact for Paul S. Madera | 03/23/2017 | |
| /s/ Joel Backman, Attorney-in-fact for Michael B. Gordon | 03/23/2017 | |
| /s/ Joel Backman, Attorney-in-fact for George H. Bischof | 03/23/2017 | |
| /s/ Joel Backman, Attorney-in-fact for Robert D. Ward | 03/23/2017 | |
| ** 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 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. | ||
