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)
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2. Date of Event Requiring Statement
(Month/Day/Year) 04/08/2011 |
3. Issuer Name and Ticker or Trading Symbol
RESPONSYS INC [ MKTG ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) 04/08/2011 |
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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) |
Common Stock | 320 | I(1) | Held Directly By Accel Keiretsu VI L.P.(2)(3) |
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 | ||||
Series A Convertible Preferred Stock | (4) | (4) | Common Stock | 13,142 | (4) | I(1) | Held Directly By Accel Keiretsu VI L.P.(2)(3) |
Series B Convertible Preferred Stock | (4) | (4) | Common Stock | 2,987 | (4) | I(1) | Held Directly By Accel Keiretsu VI L.P.(2)(3) |
Series C Convertible Preferred Stock | (4) | (4) | Common Stock | 7,839 | (4) | I(1) | Held Directly By Accel Keiretsu VI L.P.(2)(3) |
Series E Convertible Preferred Stock | (4) | (4) | Common Stock | 63,314 | (4) | I(1) | Hled Directly By Accel Keiretsu VI L.P.(2)(3) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. This Form 3/A is filed to include Accel Keiretsu VI Associates LLC in the group reports filed with the Securities and Exchange Commission on April 8, 2011. Each of the following individuals and entities is jointly filing this Form 3A and, with Accel Keiretsu VI Associates LLC, is deemed to be a member of a "group" under Section 13d-3 of the Securities Exchange Act of 1934, as amended: Accel Internet Fund II Associates L.L.C., Accel VI Associates L.L.C., Accel VI L.P., Accel VI-S L.P., Accel Internet Fund II L.P., Accel Keiretsu VI L.P., Accel Investors '98 L.P., Accel Investors '98-S L.P., Arthur C. Patterson, James W. Breyer and James R. Swartz. |
2. Each reporting person other than the referenced entity disclaims beneficial ownership of these securities except to the extent of its pecuniary interest therein. |
3. Accel Keiretsu VI Associates L.L.C. is the general partner of Accel Keiretsu VI L.P. and has sole voting and investment power. James W. Breyer, Arthur C. Patterson and James R. Swartz are the managing members of Accel Keiretsu VI Associates L.L.C. and share such powers. |
4. Each share of preferred stock is convertible into one share of common stock upon the completion of the issuer's initial public offering and has no expiration date. |
Remarks: |
/s/ Tracy L. Sedlock, as Attorney-in-Fact for Each Reporting Person | 04/12/2011 | |
** 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. |