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