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) 08/07/2020 |
3. Issuer Name and Ticker or Trading Symbol
SERVICESOURCE INTERNATIONAL, INC. [ SREV ] |
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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) |
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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 | 235,000(1) | D |
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 | ||||
Employee Stock Option (right to buy) | (2) | 05/08/2024 | Common Stock | 16,000 | $4.06 | D | |
Employee Stock Option (right to buy) | (3) | 07/20/2025 | Common Stock | 21,000 | $5.46 | D | |
Employee Stock Option (right to buy) | (4) | 08/12/2025 | Common Stock | 20,000 | $5.44 | D | |
Employee Stock Option (right to buy) | (5) | 02/17/2026 | Common Stock | 5,000 | $3.9 | D | |
Employee Stock Option (right to buy) | (6) | 09/01/2029 | Common Stock | 50,000 | $0.92 | D | |
Employee Stock Option (right to buy) | (7) | 02/07/2022 | Common Stock | 4,424 | $6.03 | D |
Explanation of Responses: |
1. The reported shares are represented by restricted stock units, or RSUs, that vest as follows: (a) 12,500 RSUs that were granted on October 10, 2016 and vest on August 17, 2020, (b) 15,000 RSUs that were granted on May 16, 2017 and vest on May 16, 2021, (c) 32,500 RSUs that were granted on May 15, 2018 and vest in two equal installments on May 15, 2021 and May 15, 2022, (d) 75,000 RSUs that were granted on December 7, 2018 and vest in three equal installments on December 7, 2020, December 7, 2021 and December 17, 2022, and (e) 100,000 RSUs that were granted on September 1, 2019 and vest in three equal installments on September 1, 2020, September 1, 2021 and September 1, 2022. |
2. One-fourth of the shares subject to the option vested on May 1, 2015 and one thirty-sixth of the remaining shares subject to the option vested monthly thereafter. |
3. One-third of the shares subject to the option vested on July 20, 2016 and one twenty-fourth of the remaining shares subject to the option vested monthly thereafter. |
4. One-fourth of the shares subject to the option vested on August 12, 2016 and one thirty-sixth of the remaining shares subject to the option vested monthly thereafter. |
5. One-third of the shares subject to the option vested on February 17, 2017 and one twenty-fourth of the remaining shares subject to the option vested monthly thereafter. |
6. The shares subject to the option vest in three equal installments on September 1, 2020, September 1, 2021, and September 1, 2022. |
7. One-fourth of the shares subject to the option vested on February 7, 2013 and one thirty-sixth of the remaining shares subject to the option vested monthly thereafter. |
Remarks: |
Exhibit List Exhibit 24 - Power of Attorney |
/s/ Patricia A. Elias, by power of attorney | 08/17/2020 | |
** 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. |