0001628280-20-007831.txt : 20200514 0001628280-20-007831.hdr.sgml : 20200514 20200514172012 ACCESSION NUMBER: 0001628280-20-007831 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200514 FILED AS OF DATE: 20200514 DATE AS OF CHANGE: 20200514 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Smith Robin L CENTRAL INDEX KEY: 0001365035 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35108 FILM NUMBER: 20879031 MAIL ADDRESS: STREET 1: C/O PHASE III MEDICAL, INC. STREET 2: 330 SOUTH SERVICE ROAD, SUITE 120 CITY: MELVILLE STATE: NY ZIP: 11747 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SERVICESOURCE INTERNATIONAL, INC. CENTRAL INDEX KEY: 0001310114 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 810578975 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 707 17TH STREET STREET 2: SUITE 2500 CITY: DENVER STATE: CO ZIP: 80202 BUSINESS PHONE: 7208898500 MAIL ADDRESS: STREET 1: 707 17TH STREET STREET 2: SUITE 2500 CITY: DENVER STATE: CO ZIP: 80202 FORMER COMPANY: FORMER CONFORMED NAME: SERVICESOURCE INTERNATIONAL LLC DATE OF NAME CHANGE: 20041129 4 1 wf-form4_158949119540170.xml FORM 4 X0306 4 2020-05-14 0 0001310114 SERVICESOURCE INTERNATIONAL, INC. SREV 0001365035 Smith Robin L C/O SERVICESOURCE INTERNATIONAL, INC. 707 17TH STREET, 25TH FLOOR DENVER CO 80202 1 0 0 0 Common Stock 2020-05-14 4 A 0 100000 0 A 117975 D The reported shares are represented by restricted stock units that vest on May 14, 2021. /s/ Patricia A. Elias, by power of attorney 2020-05-14