0001209191-17-036416.txt : 20170531
0001209191-17-036416.hdr.sgml : 20170531
20170531161643
ACCESSION NUMBER: 0001209191-17-036416
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170531
FILED AS OF DATE: 20170531
DATE AS OF CHANGE: 20170531
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: APPIAN CORP
CENTRAL INDEX KEY: 0001441683
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 11955 DEMOCRACY DRIVE
STREET 2: SUITE 1700
CITY: RESTON
STATE: VA
ZIP: 20190
BUSINESS PHONE: 703-442-8844
MAIL ADDRESS:
STREET 1: 11955 DEMOCRACY DRIVE
STREET 2: SUITE 1700
CITY: RESTON
STATE: VA
ZIP: 20190
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Calkins Matthew W
CENTRAL INDEX KEY: 0001309192
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38098
FILM NUMBER: 17881234
MAIL ADDRESS:
STREET 1: C/O MICROSTRATEGY INCORPORATED
STREET 2: 1850 TOWERS CRESCENT PLAZA
CITY: VIENNA
STATE: VA
ZIP: 22182
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-05-31
0
0001441683
APPIAN CORP
APPN
0001309192
Calkins Matthew W
11955 DEMOCRACY DRIVE
SUITE 1700
RESTON
VA
20190
1
1
1
0
CEO and President
Series A Convertible Preferred Stock
2017-05-31
4
C
0
168724
0.00
D
Class B Common Stock
168724
0
I
See Footnote
Series A Convertible Preferred Stock
2017-05-31
4
C
0
506170
0.00
D
Class B Common Stock
506170
0
I
See Footnote
Class B Common Stock
2017-05-31
4
C
0
168724
0.00
A
Class A Common Stock
168724
7174902
I
See Footnote
Class B Common Stock
2017-05-31
4
C
0
506170
0.00
A
Class A Common Stock
506170
21524710
I
See Footnote
Each share of Series A Convertible Preferred Stock converted into one share of the Issuer's Class B Common Stock upon the closing of the Issuer's initial public offering, and had no expiration date.
The reportable securities are owned directly by Wallingford LLC ("Wallingford"). The Reporting Person serves as the managing manager of Wallingford.
The reportable securities are owned directly by Calkins Family LLC (the "Family"). The Reporting Person serves as the managing manager of Family.
Each share of Class B Common Stock is convertible at any time at the option of the holder into one share of Class A Common Stock and has no expiration date. In addition, each share of Class B Common Stock will convert automatically into one share of Class A Common Stock upon (1) any transfer, whether or not for value and whether voluntary or involuntary or by operation of law, except for certain transfers described in the Issuer's certificate of incorporation, including, without limitation, certain transfers for tax and estate planning purposes or (continued to Footnote (5))
(continued from Footnote (4)) (2) the death or disability, as defined in the Issuer's certificate of incorporation, of the applicable Class B common stockholder (or nine months after the date of death or disability if the stockholder is one of the Issuer's founders). In addition, on the first trading day following the date on which the outstanding shares of Class B Common Stock represent less than 10% of the aggregate voting power of the Issuer's then outstanding capital stock, all outstanding shares of Class B Common Stock shall convert automatically into Class A Common Stock, and no additional shares of Class B Common Stock will be issued.
/s/ Lauren Ackermann, Attorney-in-Fact
2017-05-31