0000899243-16-019997.txt : 20160516 0000899243-16-019997.hdr.sgml : 20160516 20160516063849 ACCESSION NUMBER: 0000899243-16-019997 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160512 FILED AS OF DATE: 20160516 DATE AS OF CHANGE: 20160516 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MODEL N, INC. CENTRAL INDEX KEY: 0001118417 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370] IRS NUMBER: 770528806 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 1600 SEAPORT BOULEVARD STREET 2: SUITE 400 CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: (650) 610-4600 MAIL ADDRESS: STREET 1: 1600 SEAPORT BOULEVARD STREET 2: SUITE 400 CITY: REDWOOD CITY STATE: CA ZIP: 94063 FORMER COMPANY: FORMER CONFORMED NAME: MODEL T1 INC DATE OF NAME CHANGE: 20001031 FORMER COMPANY: FORMER CONFORMED NAME: MODEL N INC DATE OF NAME CHANGE: 20000707 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LARSEN CHRISTOPHER CENTRAL INDEX KEY: 0001264475 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35840 FILM NUMBER: 161650527 MAIL ADDRESS: STREET 1: 3303 HILLVIEW AVE CITY: PALO ALTO STATE: CA ZIP: 94304 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-05-12 0 0001118417 MODEL N, INC. MODN 0001264475 LARSEN CHRISTOPHER C/O MODEL N, INC. 1600 SEAPORT BOULEVARD, SUITE 400 REDWOOD CITY CA 94063 0 1 0 0 SVP and Chief Customer Officer Common Stock 2016-05-12 4 A 0 36798 0.00 A 122190 D Common Stock 2016-05-12 4 A 0 12266 0.00 A 134456 D Issuable upon the vesting and satisfaction of certain performance criteria of Performance-Based Restricted Stock Units ("PB-RSUs"). Subject to the achievement of certain minimum performance criteria based upon total stockholder return, between a minimum of 0% and a maximum of 250%, the PB-RSUs will vest as to 50% on each of the second and third annual anniversary of the vesting commencement date until such time as the PB-RSUs are 100% vested, subject to the continuing employment of the Reporting Person on each vesting date. Shares of the Issuer's common stock will be delivered to the Reporting Person upon vesting if the performance criteria have been met. Issuable upon the vesting of Restricted Stock Units ("RSUs"). 25% of the RSUs will vest on each annual anniversary of the vesting commencement date until such time as the RSUs are 100% vested, subject to the continuing employment of the Reporting Person on each vesting date. Shares of the Issuer's common stock will be delivered to the Reporting Person upon vesting. /s/ Christopher Larsen by Errol Hunter, Attorney-in-Fact 2016-05-16