0001209191-21-061550.txt : 20211025 0001209191-21-061550.hdr.sgml : 20211025 20211025181716 ACCESSION NUMBER: 0001209191-21-061550 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211022 FILED AS OF DATE: 20211025 DATE AS OF CHANGE: 20211025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WALSKE STEVEN CENTRAL INDEX KEY: 0001085698 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38982 FILM NUMBER: 211345228 MAIL ADDRESS: STREET 1: C/O PARAMETRIC TECHNOLOGY CORP STREET 2: 128 TECHNOLOGY DR CITY: WALTHAM STATE: MA ZIP: 02154 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Medallia, Inc. CENTRAL INDEX KEY: 0001540184 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 575 MARKET STREET STREET 2: SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: (650) 321-3000 MAIL ADDRESS: STREET 1: 575 MARKET STREET STREET 2: SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 FORMER COMPANY: FORMER CONFORMED NAME: Medallia Inc. DATE OF NAME CHANGE: 20120123 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-10-22 0 0001540184 Medallia, Inc. MDLA 0001085698 WALSKE STEVEN C/O MEDALLIA, INC. 575 MARKET STREET, SUITE 1850 SAN FRANCISCO CA 94105 1 0 0 0 Common Stock 2021-10-22 4 A 0 433 0.00 A 515799 D The reported shares are represented by restricted stock units, or RSUs, all of which were vested on the award date. /s/ Roxanne Oulman, by power of attorney 2021-10-25