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