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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
QLIK TECHNOLOGIES INC [ QLIK ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 07/16/2011 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) 07/19/2011 |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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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 | 07/16/2011 | M | 7,500 | A | (1)(2) | 7,500(3)(4) | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 |
Explanation of Responses: |
1. Each restricted stock unit ("RSU") represents a contingent right to receive one share of the Issuer's common stock. |
2. The Reporting Person received an RSU grant on July 16, 2010, which vested 100% on July 16, 2011. |
3. In addition, 1,869,806 shares are owned directly by Jerusalem Venture Partners IV, L.P. ("JVP IV"); 76,070 shares are owned directly by JVP IV Annex Fund, L.P. ("JVP IV AF"); 7,025 shares are owned directly by JVP IV Annex Entrepreneur Fund, L.P. ("JVP IV AEF"); 44,987 shares are owned directly by Jerusalem Venture Partners IV (Israel), L.P. ("JVP IV I"); 16,749 shares are owned directly by Jerusalem Venture Partners Entrepreneurs Fund IV, L.P. ("JVPEF IV"); and 15,960 Shares are owned directly by Jerusalem Venture Partners IV-A, L.P. ("JVP IV-A"). The Reporting Person is the officer of JVP Corp. IV, the general partner of the general partners of each of JVP IV, JVP IV AF, JVP IV AEF, JVP IV I, JVPEF IV, and JVP IV-A. The Reporting Person disclaims beneficial ownership of the shares held by each of JVP IV, JVP IV AF, JVP IV AEF, JVP IV I, JVPEF IV, and JVP IV-A, except to the extent of any pecuniary interest therein. |
4. This form is filed to amend a Form 4 originally filed on July 19, 2011 by the Reporting Person to correct the number of securities beneficially owned. |
Remarks: |
/s/ Deborah C. Lofton, Attorney-in-Fact for Erel Margalit | 07/19/2011 | |
** 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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |