0001366561-21-000006.txt : 20210222 0001366561-21-000006.hdr.sgml : 20210222 20210222195923 ACCESSION NUMBER: 0001366561-21-000006 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210131 FILED AS OF DATE: 20210222 DATE AS OF CHANGE: 20210222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McIlwain Matthew S CENTRAL INDEX KEY: 0001381752 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38464 FILM NUMBER: 21662513 MAIL ADDRESS: STREET 1: 1000 SECOND AVENUE STREET 2: SUITE 3700 CITY: SEATTLE STATE: WA ZIP: 98104 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SMARTSHEET INC CENTRAL INDEX KEY: 0001366561 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 202954357 STATE OF INCORPORATION: WA FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 10500 NE 8TH STREET STREET 2: SUITE 1300 CITY: BELLEVUE STATE: WA ZIP: 98004 BUSINESS PHONE: 855-420-2395 MAIL ADDRESS: STREET 1: 10500 NE 8TH STREET STREET 2: SUITE 1300 CITY: BELLEVUE STATE: WA ZIP: 98004 FORMER COMPANY: FORMER CONFORMED NAME: SMARTSHEET.COM INC DATE OF NAME CHANGE: 20060619 5 1 wf-form5_161404194314399.xml FORM 5 X0306 5 2021-01-31 0 0 0 0001366561 SMARTSHEET INC SMAR 0001381752 McIlwain Matthew S C/O MADRONA VENTURE GROUP 999 THIRD AVE., 34TH FLOOR SEATTLE WA 98104 1 0 0 0 Class A Common Stock 2021-01-05 5 G 0 5000 0 D 103075 D Represents shares of the issuer's Class A Common Stock that the reporting person donated as a gift. /s/ Paul Porrini as attorney-in-fact for Matthew McIlwain 2021-02-23