SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
MARGALIT EREL N

(Last) (First) (Middle)
C/O JERUSALEM VENTURE PARTNERS
HEBRON ROAD 24

(Street)
JERUSALEM L3 93542

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
QLIK TECHNOLOGIES INC [ QLIK ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
03/16/2010
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 07/15/2010 C 9,181,178 A (1) 9,530,235 I See Footnote(2)
Common Stock 07/15/2010 C 5,297,226 A (1) 14,827,461 I See Footnote(2)
Common Stock 07/15/2010 C 361,990 A (1) 603,243 I See Footnote(3)
Common Stock 07/15/2010 C 33,420 A (1) 55,693 I See Footnote(4)
Common Stock 07/15/2010 C 220,899 A (1) 229,295 I See Footnote(5)
Common Stock 07/15/2010 C 127,451 A (1) 356,746 I See Footnote(5)
Common Stock 07/15/2010 C 82,240 A (1) 85,367 I See Footnote(6)
Common Stock 07/15/2010 C 47,448 A (1) 132,815 I See Footnote(6)
Common Stock 07/15/2010 C 78,414 A (1) 81,359 I See Footnote(7)
Common Stock 07/15/2010 C 45,202 A (1) 126,561 I See Footnote(7)
Common Stock 03/16/2010 S(8) 22,273 D $5.14 241,253 I See Footnote(3)
Common Stock 03/16/2010 P(8) 22,273 A $5.14 22,273 I See Footnote(4)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Restricted Stock Units (9) 07/16/2010 A 7,500 07/15/2011 (10) Common Stock 7,500 $0 7,500 D
Series A Preferred Stock (1) 07/15/2010 C 9,181,178 (11) (10) Common Stock 9,181,178 (1) 0 I See Footnote(2)
Series AA Preferred Stock (1) 07/15/2010 C 5,297,226 (11) (10) Common Stock 5,297,226 (1) 0 I See Footnote(2)
Series AA Preferred Stock (1) 07/15/2010 C 361,990 (11) (10) Common Stock 361,990 (1) 0 I See Footnote(3)
Series AA Preferred Stock (1) 07/15/2010 C 33,420 (11) (10) Common Stock 33,420 (1) 0 I See Footnote(4)
Series A Preferred Stock (1) 07/15/2010 C 220,899 (11) (10) Common Stock 220,899 (1) 0 I See Footnote(5)
Series AA Preferred Stock (1) 07/15/2010 C 127,451 (11) (10) Common Stock 127,451 (1) 0 I See Footnote(5)
Series A Preferred Stock (1) 07/15/2010 C 82,240 (11) (10) Common Stock 82,240 (1) 0 I See Footnote(6)
Series AA Preferred Stock (1) 07/15/2010 C 47,448 (11) (10) Common Stock 47,448 (1) 0 I See Footnote(6)
Series A Preferred Stock (1) 07/15/2010 C 78,414 (11) (10) Common Stock 78,414 (1) 0 I See Footnote(7)
Series AA Preferred Stock (1) 07/15/2010 C 45,202 (11) (10) Common Stock 45,202 (1) 0 I See Footnote(7)
Series AA Preferred Stock (1) 03/16/2010 S(8) 33,420 (11) (10) Common Stock 33,420 $5.14 361,990 I See Footnote(3)
Series AA Preferred Stock (1) 03/16/2010 P(8) 33,420 (11) (10) Common Stock 33,420 $5.14 33,420 I See Footnote(4)
1. Name and Address of Reporting Person*
MARGALIT EREL N

(Last) (First) (Middle)
C/O JERUSALEM VENTURE PARTNERS
HEBRON ROAD 24

(Street)
JERUSALEM L3 93542

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
JERUSALEM VENTURE PARTNERS IV LP

(Last) (First) (Middle)
C/O JERUSALEM VENTURE PARTNERS
HEBRON ROAD 24

(Street)
JERUSALEM L3 93542

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
JVP IV Annex Fund, L.P.

(Last) (First) (Middle)
C/O JERUSALEM VENTURE PARTNERS
HEBRON ROAD 24

(Street)
JERUSALEM L3 93542

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
JVP IV Annex Entrepreneur Fund, L.P.

(Last) (First) (Middle)
C/O JERUSALEM VENTURE PARTNERS
HEBRON ROAD 24

(Street)
JERUSALEM L3 93542

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
JERUSALEM VENTURE PARTNERS IV ISRAEL LP

(Last) (First) (Middle)
C/O JERUSALEM VENTURE PARTNERS
HEBRON ROAD 24

(Street)
JERUSALEM L3 93542

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
JERUSALEM VENTURE PARTNERS ENTREPRENEURS FUND IV LP

(Last) (First) (Middle)
C/O JERUSALEM VENTURE PARTNERS
HEBRON ROAD 24

(Street)
JERUSALEM L3 93542

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
JERUSALEM VENTURE PARTNERS IV A LP

(Last) (First) (Middle)
C/O JERUSALEM VENTURE PARTNERS
HEBRON ROAD 24

(Street)
JERUSALEM L3 93542

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
JERUSALEM PARTNERS IV LP

(Last) (First) (Middle)
C/O JERUSALEM VENTURE PARTNERS
HEBRON ROAD 24

(Street)
JERUSALEM L3 93542

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
JP Media V, L.P.

(Last) (First) (Middle)
C/O JERUSALEM VENTURE PARTNERS
HEBRON ROAD 24

(Street)
JERUSALEM L3 93542

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
JERUSALEM PARTNERS IV - VENTURE CAPITAL LP

(Last) (First) (Middle)
C/O JERUSALEM VENTURE PARTNERS
HEBRON ROAD 24

(Street)
JERUSALEM L3 93542

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. Each outstanding share of preferred stock automatically converted into 1 share of common stock, immediately prior to the closing of the Issuer's initial public offering, for no additional consideration.
2. The reportable securities are owned directly by Jerusalem Venture Partners IV, L.P. ("JVP IV"). Erel Margalit (the "Officer") is the officer of JVP Corp. IV ("JVP Corp"). JVP Corp is the general partner of Jerusalem Partners IV, L.P. ("JP IV"), which is the general partner of JVP IV. The Officer, JVP Corp and JP IV may be deemed to share voting and dispositive power over the shares held by JVP IV and disclaim beneficial ownership of shares held by JVP IV except to the extent of any pecuniary interest therein.
3. The reportable securities are owned directly by JVP IV Annex Fund, L.P. ("JVP IV AF"). The Officer is the officer of JVP Corp. JVP Corp is the general partner of JP Media V, L.P. ("JPM V"), which is the general partner of JVP IV AF. The Officer, JVP Corp and JPM V may be deemed to share voting and dispositive power over the shares held by JVP IV AF and disclaim beneficial ownership of shares held by JVP IV AF except to the extent of any pecuniary interest therein.
4. The reportable securities are owned directly by JVP IV Annex Entrepreneur Fund, L.P. ("JVP IV AEF"). The Officer is the officer of JVP Corp. JVP Corp is the general partner of JPM V, which is the general partner of JVP IV AEF. The Officer, JVP Corp and JPM V may be deemed to share voting and dispositive power over the shares held by JVP IV AEF and disclaim beneficial ownership of shares held by JVP IV AEF except to the extent of any pecuniary interest therein.
5. The reportable securities are owned directly by Jerusalem Venture Partners IV (Israel), L.P. ("JVP IV I"). The Officer is the officer of JVP Corp. JVP Corp is the general partner of Jerusalem Partners IV - Venture Capital, L.P. ("JP IV-VC"), which is the general partner of JVP IV I. The Officer, JVP Corp and JP IV-VC may be deemed to share voting and dispositive power over the shares held by JVP IV I and disclaim beneficial ownership of shares held by JVP IV I except to the extent of any pecuniary interest therein.
6. The reportable securities are owned directly by Jerusalem Venture Partners Entrepreneurs Fund IV, L.P. ("JVPEF IV"). The Officer is the officer of JVP Corp. JVP Corp is the general partner of JP IV, which is the general partner of JVPEF IV. The Officer, JVP Corp and JP IV may be deemed to share voting and dispositive power over the shares held by JVPEF IV and disclaim beneficial ownership of shares held by JVPEF IV except to the extent of any pecuniary interest therein.
7. The reportable securities are owned directly by Jerusalem Venture Partners IV-A, L.P. ("JVP IV-A"). The Officer is the officer of JVP Corp. JVP Corp is the general partner of JP IV, which is the general partner of JVP IV-A. The Officer, JVP Corp and JP IV may be deemed to share voting and dispositive power over the shares held by JVP IV-A and disclaim beneficial ownership of shares held by JVP IV-A except to the extent of any pecuniary interest therein.
8. This transaction represents the internal rebalancing of Series AA Preferred Stock and Common Stock between JVP IV AF and JVP IV AEF. Following the rebalancing transactions reported herein, the amount of securities beneficially owned in the aggregate by the Reporting Persons did not change. However, as a result of this rebalancing, on March 16, 2010 the Officer acquired an additional pecuniary interest in the shares of the issuer held in the aggregate by the JVP family of funds as reported hereunder.
9. Each restricted stock unit represents a contingent right to receive one share of Qlik Technologies common stock.
10. Not Applicable.
11. Immediately.
Remarks:
Since there are 11 joint filers with this transaction and EDGAR will not allow for entry of more than 10 joint filers, this Form 4 is being filed in conjunction with a Form 4 for JVP Corp. IV.
/s/ Erel Margalit 07/16/2010
/s/ Erel Margalit, Authorized signatory for Jerusalem Venture Partners IV, L.P. 07/16/2010
/s/ Erel Margalit, Authorized signatory for JVP IV Annex Fund, L.P. 07/16/2010
/s/ Erel Margalit, Authorized signatory for JVP IV Annex Entrepreneur Fund, L.P. 07/16/2010
/s/ Erel Margalit, Authorized signatory for Jerusalem Venture Partners IV (Israel), L.P. 07/16/2010
/s/ Erel Margalit, Authorized signatory for Jerusalem Venture Partners Entrepreneurs Fund IV, L.P. 07/16/2010
/s/ Erel Margalit, Authorized signatory for Jerusalem Venture Partners IV-A, L.P. 07/16/2010
/s/ Erel Margalit, Authorized signatory for Jerusalem Partners IV, L.P. 07/16/2010
/s/ Erel Margalit, Authorized signatory for JP Media V, L.P. 07/16/2010
/s/ Erel Margalit, Authorized signatory for Jerusalem Partners IV ? Venture Capital, L.P. 07/16/2010
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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