0001209191-21-037366.txt : 20210602 0001209191-21-037366.hdr.sgml : 20210602 20210602175820 ACCESSION NUMBER: 0001209191-21-037366 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210528 FILED AS OF DATE: 20210602 DATE AS OF CHANGE: 20210602 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DAUERMAN MITCHELL K CENTRAL INDEX KEY: 0001249669 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38982 FILM NUMBER: 21990481 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 2021-05-28 0 0001540184 Medallia, Inc. MDLA 0001249669 DAUERMAN MITCHELL K C/O MEDALLIA, INC. 575 MARKET STREET, SUITE 1850 SAN FRANCISCO CA 94105 1 0 0 0 Common Stock 2021-05-28 4 A 0 7791 0.00 A 33554 D The reported shares are represented by restricted stock units, or RSUs, which vest on the earlier of (i) May 28, 2022 or (ii) the day prior to the date of the Issuer's next annual meeting of stockholders. /s/ Drew Grasham, by power of attorney 2021-06-02