0001118417-19-000103.txt : 20191120
0001118417-19-000103.hdr.sgml : 20191120
20191120165004
ACCESSION NUMBER: 0001118417-19-000103
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191118
FILED AS OF DATE: 20191120
DATE AS OF CHANGE: 20191120
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Anderson, Mark, Albert
CENTRAL INDEX KEY: 0001671704
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35840
FILM NUMBER: 191234829
BUSINESS ADDRESS:
STREET 1: C/O MODEL N, INC.,1600 SEAPORT BOULEVARD
STREET 2: SUITE 400, PACIFIC SHORES CENTER - BLD.6
CITY: REDWOOD CITY
STATE: CA
ZIP: 94063
BUSINESS PHONE: 650-610-4600
MAIL ADDRESS:
STREET 1: C/O MODEL N, INC.,1600 SEAPORT BOULEVARD
STREET 2: SUITE 400, PACIFIC SHORES CENTER - BLD.6
CITY: REDWOOD CITY
STATE: CA
ZIP: 94063
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: 777 MARINERS ISLAND BOULEVARD
STREET 2: SUITE 300
CITY: SAN MATEO
STATE: CA
ZIP: 94404
BUSINESS PHONE: (650) 610-4600
MAIL ADDRESS:
STREET 1: 777 MARINERS ISLAND BOULEVARD
STREET 2: SUITE 300
CITY: SAN MATEO
STATE: CA
ZIP: 94404
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
4
1
wf-form4_157428658770332.xml
FORM 4
X0306
4
2019-11-18
0
0001118417
MODEL N, INC.
MODN
0001671704
Anderson, Mark, Albert
C/O MODEL N, INC.
777 MARINERS ISLAND BOULEVARD, SUITE 300
SAN MATEO
CA
94404
0
1
0
0
SVP, Global Services
Common Stock
2019-11-18
4
S
0
254
31.26
D
125311
D
Common Stock
2019-11-18
4
S
0
435
31.26
D
124876
D
Common Stock
2019-11-18
4
S
0
983
31.26
D
123893
D
All shares reported as disposed of in this Form 4 were sold by the Reporting Person in order to pay the federal and state tax withholding obligations resulting from the vesting of the Reporting Person's Restricted Stock Units ("RSUs") and performance-based RSUs. The Reporting Person did not sell or otherwise dispose of any of the shares reported on this Form 4 for any reason other than to cover required taxes.
/s/Mark Anderson by Errol Hunter, Attorney-in-Fact
2019-11-20