0001477932-15-007219.txt : 20151119
0001477932-15-007219.hdr.sgml : 20151119
20151119143619
ACCESSION NUMBER: 0001477932-15-007219
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20151118
FILED AS OF DATE: 20151119
DATE AS OF CHANGE: 20151119
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: INSTRUCTURE INC
CENTRAL INDEX KEY: 0001355754
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 6330 SOUTH 3000 EAST, SUITE 700
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84121
BUSINESS PHONE: (800) 203-6755
MAIL ADDRESS:
STREET 1: 6330 SOUTH 3000 EAST, SUITE 700
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84121
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MADSEN KENT
CENTRAL INDEX KEY: 0001259434
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37629
FILM NUMBER: 151243392
MAIL ADDRESS:
STREET 1: 15 W. SOUTH TEMPLE #500
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84101
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Epic Expansion Capital, LLC
CENTRAL INDEX KEY: 0001658325
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37629
FILM NUMBER: 151243393
BUSINESS ADDRESS:
STREET 1: 15 W. SOUTH TEMPLE #500
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84101
BUSINESS PHONE: (801) 524-8939
MAIL ADDRESS:
STREET 1: 15 W. SOUTH TEMPLE #500
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84101
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ZIONS SBIC LLC
CENTRAL INDEX KEY: 0001137502
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37629
FILM NUMBER: 151243394
BUSINESS ADDRESS:
STREET 1: ONE SOUTH MAIN STREET
STREET 2: SUITE 1660
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84133
BUSINESS PHONE: 8015248939
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Epic Expansion Capital Annex, LLC
CENTRAL INDEX KEY: 0001658326
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37629
FILM NUMBER: 151243395
BUSINESS ADDRESS:
STREET 1: 15 W. SOUTH TEMPLE #500
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84101
BUSINESS PHONE: (801) 524-8939
MAIL ADDRESS:
STREET 1: 15 W. SOUTH TEMPLE #500
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84101
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: EPIC VENTURE FUND IV, LLC
CENTRAL INDEX KEY: 0001456865
STATE OF INCORPORATION: DE
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37629
FILM NUMBER: 151243396
BUSINESS ADDRESS:
STREET 1: 15 W. SOUTH TEMPLE #500
CITY: Salt Lake City
STATE: UT
ZIP: 84101
BUSINESS PHONE: 801-524-8939
MAIL ADDRESS:
STREET 1: 15 W. SOUTH TEMPLE #500
CITY: Salt Lake City
STATE: UT
ZIP: 84101
FORMER NAME:
FORMER CONFORMED NAME: EPIC VENTURE FUND IV LLC
DATE OF NAME CHANGE: 20090223
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2015-11-18
0
0001355754
INSTRUCTURE INC
INST
0001456865
EPIC VENTURE FUND IV, LLC
C/O EPIC VENTURES
15 W. SOUTH TEMPLE #500
SALT LAKE CITY
UT
84101
0
0
1
0
0001658326
Epic Expansion Capital Annex, LLC
C/O EPIC VENTURES
15 W. SOUTH TEMPLE #500
SALT LAKE CITY
UT
84101
0
0
1
0
0001137502
ZIONS SBIC LLC
C/O EPIC VENTURES
15 W. SOUTH TEMPLE #500
SALT LAKE CITY
UT
84101
0
0
1
0
0001658325
Epic Expansion Capital, LLC
C/O EPIC VENTURES
15 W. SOUTH TEMPLE #500
SALT LAKE CITY
UT
84101
0
0
1
0
0001259434
MADSEN KENT
C/O EPIC VENTURES
15 W. SOUTH TEMPLE #500
SALT LAKE CITY
UT
84101
0
0
1
0
Common Stock
2015-11-18
4
C
0
2578199
0
A
2672811
D
Common Stock
2015-11-18
4
C
0
319306
0
A
572806
I
By Epic Expansion Capital Annex, LLC
Common Stock
2015-11-18
4
C
0
1168549
0
A
1204460
I
By Zions SBIC LLC
Common Stock
2015-11-18
4
C
0
374999
0
A
374999
I
Epic Expansion Capital, LLC
Common Stock
39149
I
By Kent I. Madsen
Series A Preferred Stock
2015-11-18
4
C
0
319306
0
D
Common Stock
319306
0
I
By Epic Expansion Capital Annex, LLC
Series A Preferred Stock
2015-11-18
4
C
0
1352194
0
D
Common Stock
1352194
0
D
Series A Preferred Stock
2015-11-18
4
C
0
26623
0
D
Common Stock
26623
0
I
By Zions SBIC LLC
Series B Preferred Stock
2015-11-18
4
C
0
784314
0
D
Common Stock
784314
0
D
Series B Preferred Stock
2015-11-18
4
C
0
784313
0
D
Common Stock
784313
0
I
By Zions SBIC LLC
Series C Preferred Stock
2015-11-18
4
C
0
378799
0
D
Common Stock
378799
0
D
Series C Preferred Stock
2015-11-18
4
C
0
143777
0
D
Common Stock
143777
0
I
By Zions SBIC LLC
Series D Preferred Stock
2015-11-18
4
C
0
62892
0
D
Common Stock
62892
0
D
Series D Preferred StockCommon Stock
2015-11-18
4
C
0
213836
0
D
Common Stock
213836
0
I
By Zions SBIC LLC
Series E Preferred Stock
2015-11-18
4
C
0
273710
0
D
Common Stock
374999
0
I
By Epic Expansion Capital, LLC
Epic Management Partners, LLC (EMP) is the investment manager of Epic Venture Fund IV, LLC (EVF IV), Epic Expansion Capital Annex, LLC (EECA) and Epic Expansion Capital, LLC (EEC) and has sole voting and investment power with regard to the shares held directly by EVF IV, EECA and EEC. E. Nicholaus Efstratis and Kent I. Madsen are the managers of EMP and, therefore, may be deemed to share voting and investment power with regard to the shares held by EVF IV, EECA and EEC. Each of such individuals disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein. The inclusion of these securities shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or any other purpose.
ZWMC IV, L.L.C. (ZWMC) is the investment manager of Zions SBIC LLC (Zions SBIC) and has sole voting and investment power with regard to the shares held directly by Zions SBIC. E. Nicholaus Efstratis and Kent I. Madsen are the managers of ZWMC and, therefore, may be deemed to share voting and investment power with regard to the shares held by Zions SBIC. Each of such individuals disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein. The inclusion of these securities shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or any other purpose.
These shares are owned directly by Kent I. Madsen.
The Series A Preferred Stock converted into Common Stock of the Issuer on a 1-to-1 basis upon the closing of the initial public offering of the Issuer.
The Series B Preferred Stock converted into Common Stock of the Issuer on a 1-to-1 basis upon the closing of the initial public offering of the Issuer.
The Series C Preferred Stock converted into Common Stock of the Issuer on a 1-to-1 basis upon the closing of the initial public offering of the Issuer.
The Series D Preferred Stock converted into Common Stock of the Issuer on a 1-to-1 basis upon the closing of the initial public offering of the Issuer.
The Series E Preferred Stock converted into Common Stock of the Issuer on a 1-to-3.700625 basis upon closing of the initial public offering of the Issuer.
Not applicable.
/s/ Kent I. Madsen, Manager of Epic Management Partners, LLC, Investment Manager of Epic Venture Fund IV, LLC
2015-11-19
/s/ Kent I. Madsen, Manager of ZWMC, IV, L.L.C., Investment Manager of Zions SBIC LLC
2015-11-19
/s/ Kent I. Madsen, Manager of Epic Management Partners, LLC, Investment Manager of Epic Expansion Capital Annex, LLC
2015-11-19
/s/ Kent I. Madsen, Manager of Epic Management Partners, LLC, Investment Manager of Epic Expansion Capital, LLC
2015-11-19
/s/ Kent I. Madsen, an individual
2015-11-19