0001209191-21-033758.txt : 20210518
0001209191-21-033758.hdr.sgml : 20210518
20210518193003
ACCESSION NUMBER: 0001209191-21-033758
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210515
FILED AS OF DATE: 20210518
DATE AS OF CHANGE: 20210518
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KILGORE LESLIE J
CENTRAL INDEX KEY: 0001218352
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38982
FILM NUMBER: 21937879
MAIL ADDRESS:
STREET 1: 100 WINCHESTER CIRCLE
CITY: LOS GATOS
STATE: CA
ZIP: 95032
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
2021-05-15
0
0001540184
Medallia, Inc.
MDLA
0001218352
KILGORE LESLIE J
C/O MEDALLIA, INC.
575 MARKET STREET, SUITE 1850
SAN FRANCISCO
CA
94105
1
0
0
0
Common Stock
2021-05-15
4
A
0
585
0.00
A
246776
D
Common Stock
29828
I
See footnote
The reported shares are represented by restricted stock units, or RSUs, all of which were vested on the award date.
The shares are held of record by the JLK Revocable Trust dated October 13, 2003 for which the reporting person serves as a trustee.
/s/ Drew Grasham, by power of attorney
2021-05-18