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*
Tucker Therese

(Last) (First) (Middle)
21300 VICTORY BLVD., 12TH FLOOR

(Street)
WOODLAND HILLS CA 91367

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
BLACKLINE, INC. [ BL ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Executive Chair
3. Date of Earliest Transaction (Month/Day/Year)
10/12/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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 10/12/2021 S(1) 1,266 D $117.6358(2) 1,612,516 I Brian & Therese Tucker Living Trust
Common Stock 10/12/2021 S(1) 3,030 D $118.7266(3) 1,609,486 I Brian & Therese Tucker Living Trust
Common Stock 10/12/2021 S(1) 5,366 D $119.734(4) 1,604,120 I Brian & Therese Tucker Living Trust
Common Stock 10/12/2021 S(1) 5,999 D $120.1784(5) 1,598,121 I Brian & Therese Tucker Living Trust
Common Stock 156,223 D
Common Stock 100,178 I Brian & Therese Tucker Charitable Remainder Trust
Common Stock 100,178 I Tucker Family CLAT
Common Stock 874,128 I Tucker Legacy Trust
Common Stock 129,897 I Tucker Legacy Trust II
Common Stock 577,200 I Isaac Tucker 2012 Irrevocable Trust
Common Stock 577,200 I Roseanna Tucker 2012 Irrevocable Trust
Common Stock 250,916 I Tucker Seimetz Safety Net Trust
Common Stock 54,074 I Claire Seimetz 2015 Trust
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
Explanation of Responses:
1. The sale transaction reported on this Form 4 was effected pursuant to a Rule 10b5-1 trading plan adopted by the Reporting Person on November 27, 2020.
2. The sale price represents the weighted-average price of shares sold ranging from $117.07 to $117.985 per share. Upon request by the Securities and Exchange Commission staff, the Issuer or a security holder of the Issuer, the Reporting Person will provide full information regarding the number of shares sold at each separate price within the range set forth in this Form 4.
3. The sale price represents the weighted-average price of shares sold ranging from $118.10 to $119.055 per share. Upon request by the Securities and Exchange Commission staff, the Issuer or a security holder of the Issuer, the Reporting Person will provide full information regarding the number of shares sold at each separate price within the range set forth in this Form 4.
4. The sale price represents the weighted-average price of shares sold ranging from $119.10 to $120.065 per share. Upon request by the Securities and Exchange Commission staff, the Issuer or a security holder of the Issuer, the Reporting Person will provide full information regarding the number of shares sold at each separate price within the range set forth in this Form 4.
5. The sale price represents the weighted-average price of shares sold ranging from $120.07 to $120.415 per share. Upon request by the Securities and Exchange Commission staff, the Issuer or a security holder of the Issuer, the Reporting Person will provide full information regarding the number of shares sold at each separate price within the range set forth in this Form 4.
Remarks:
/s/ Karole Morgan-Prager, Attorney-in-Fact 10/12/2021
** 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.