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*
GRANITE VENTURES LLC

(Last) (First) (Middle)
300 MONTGOMERY STREET, SUITE 638

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Anaplan, Inc. [ PLAN ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
06/05/2019
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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)
Code V Amount (A) or (D) Price
Common Stock 06/05/2019 J(1) 22,453 A (1) 126,030 D
Common Stock 06/05/2019 J(2) 126,030 D (2) 0 D
Common Stock 06/05/2019 J(2) 99,947 D (2) 0 I By Granite Ventures Entrepreneurs Fund II, L.P.(3)
Common Stock 06/05/2019 J(2) 1,500,000 D (2) 10,851,794 I By Granite Ventures II, L.P.(3)
Common Stock 06/05/2019 J(2) 250,036 D (2) 0 I By GV Anaplan SPV, L.P.(3)
Common Stock 06/05/2019 J(1) 51,354 A (1) 55,354 D(4)
Common Stock 06/05/2019 J(1) 29,580 A (1) 29,580 I By Trust(5)
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
1. Name and Address of Reporting Person*
GRANITE VENTURES LLC

(Last) (First) (Middle)
300 MONTGOMERY STREET, SUITE 638

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Granite Ventures II L P

(Last) (First) (Middle)
300 MONTGOMERY STREET, SUITE 638

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
GRANITE VENTURES ENTREPRENEURS FUND II LP

(Last) (First) (Middle)
300 MONTGOMERY STREET, SUITE 638

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
GV Anaplan SPV, L.P.

(Last) (First) (Middle)
300 MONTGOMERY STREET, SUITE 638

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Granite Management II, LLC

(Last) (First) (Middle)
300 MONTGOMERY STREET, SUITE 638

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Berterretche Jacqueline

(Last) (First) (Middle)
300 MONTGOMERY STREET, SUITE 638

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
McKay Christopher

(Last) (First) (Middle)
300 MONTGOMERY STREET, SUITE 638

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. Represents an acquisition of securities from an in-kind distribution, and not a purchase or sale, without additional consideration paid, and is therefore an exempt, non-matchable acquisition pursuant to Section 16(b).
2. Represents a pro-rata in-kind distribution, and not a purchase or sale, without additional consideration to its partners.
3. Granite Management II, LLC is the general partner of Granite Ventures II, L.P. and Granite Ventures Entrepreneurs Fund II, L.P. Granite Ventures, LLC is the general partner of GV Anaplan SPV, L.P. Standish O'Grady, a member of our board of directors, Jacqueline Berterretche and Christopher McKay are managing directors of the general partner entities of these funds that directly hold shares and as such Mr. O'Grady, Ms. Berterreche and Mr. McKay may be deemed to have voting and investment power with respect to such shares. These individuals disclaim beneficial ownership of the shares held by the aforementioned entities except to the extent of any pecuniary interest therein.
4. Represents shares held directly by Christopher McKay.
5. Represents shares held by the Dominic and Jacqueline Berterretche Revocable Trust.
Remarks:
GRANITE MANAGEMENT II, LLC, By Granite Ventures, LLC, Its Managing Member, By /s/ Jacqueline Berterretche, Printed Name: Jacqueline Berterretche Title: Member 06/06/2019
GRANITE VENTURES, LLC, By /s/ Jacqueline Berterretche, Printed Name: Jacqueline Berterretche, Title: Member 06/06/2019
GRANITE VENTURES II, L.P., By Granite Management II, LLC, Its General Partner, By /s/ Jacqueline Berterretche, Printed Name: Jacqueline Berterretche, Title: Member 06/06/2019
GRANITE VENTURES ENTREPRENEURS FUND II, L.P., By Granite Management II, LLC, Its General Partner, By /s/ Jacqueline Berterretche, Printed Name: Jacqueline Berterretche, Title: Member 06/06/2019
GV ANAPLAN SPV, L.P. By Granite Ventures, LLC, Its General Partner, By /s/ Jacqueline Berterretche, Printed Name: Jacqueline Berterretche, Title: Member 06/06/2019
By /s/ Jacqueline Berterretche, Jacqueline Berterretche 06/06/2019
By /s/ Christopher McKay, Christopher McKay 06/06/2019
** 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 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).
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