0001209191-12-028784.txt : 20120517 0001209191-12-028784.hdr.sgml : 20120517 20120517130516 ACCESSION NUMBER: 0001209191-12-028784 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120515 FILED AS OF DATE: 20120517 DATE AS OF CHANGE: 20120517 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DIGITAL MEDIA & COMMUNICATINS III E CV CENTRAL INDEX KEY: 0001260020 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35232 FILM NUMBER: 12851120 MAIL ADDRESS: STREET 1: 75 STATE STREET STREET 2: C/O ADVENT INTERNAITONAL CORP CITY: BOSTON STATE: MA ZIP: 01209 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: WAGEWORKS, INC. CENTRAL INDEX KEY: 0001158863 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 943351864 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1100 PARK PLACE STREET 2: 4TH FLOOR CITY: SAN MATEO STATE: CA ZIP: 94403 BUSINESS PHONE: 650-557-5200 MAIL ADDRESS: STREET 1: 1100 PARK PLACE STREET 2: 4TH FLOOR CITY: SAN MATEO STATE: CA ZIP: 94403 FORMER COMPANY: FORMER CONFORMED NAME: WAGEWORKS INC DATE OF NAME CHANGE: 20010907 4 1 doc4.xml FORM 4 SUBMISSION X0305 4 2012-05-15 1 0001158863 WAGEWORKS, INC. WAGE 0001260020 DIGITAL MEDIA & COMMUNICATINS III E CV C/O ADVENT INTERNATIONAL CORPORATION 75 STATE STREET, 29TH FLOOR BOSTON MA 02109 0 0 0 1 Member of group no longer >10% Common Stock 2012-05-15 4 C 0 69 A 2353 D Common Stock 2012-05-15 4 C 0 23 A 2376 D Common Stock 2012-05-15 4 C 0 70839 A 73215 D Common Stock 2012-05-15 4 C 0 6016 A 79231 D Common Stock 2012-05-15 4 C 0 14685 A 93916 D Series A-1 Preferred Stock 2012-05-15 4 C 0 47 0.00 D Common Stock 69 0 D Series A-2 Preferred Stock 2012-05-15 4 C 0 27 0.00 D Common Stock 23 0 D Series C Preferred Stock 2012-05-15 4 C 0 141678 0.00 D Common Stock 70839 0 D Series D Preferred Stock 2012-05-15 4 C 0 12033 0.00 D Common Stock 6016 0 D Series E Preferred Stock 2012-05-15 4 C 0 29370 0.00 D Common Stock 14685 0 D Series E-1 Warrant (Right to Buy) 2.29 2012-05-15 4 C 0 48448 0.00 D 2010-07-30 2014-06-30 Series E-1 Preferred Stock 48448 0 D Common Stock Warrant (Right to Buy) 4.58 2012-05-15 4 C 0 24224 0.00 A 2010-07-30 2014-06-30 Common Stock 24224 24224 D Each share of the Issuer's Series A-1 preferred stock automatically converted into 1.47059 shares of common stock immediately prior to the closing of the Issuer's initial public offering and had no expiration date. Each share of the Issuer's Series A-2 preferred stock automatically converted into 0.85208 shares of common stock immediately prior to the closing of the Issuer's initial public offering and had no expiration date. Each share of the Issuer's Series C preferred stock, Series D preferred stock and Series E preferred stock automatically converted into 0.50 shares of common stock immediately prior to the closing of the Issuer's initial public offering and had no expiration date. The Series E-1 warrants to purchase shares of Series E preferred stock automatically converted into warrants to purchase 0.50 shares of common stock, at an exercise price of $4.58 per share, immediately prior to the closing of the Issuer's initial public offering. /s/ Jarlyth H. Gibson, Compliance Officer 2012-05-17