0000899243-17-011447.txt : 20170502 0000899243-17-011447.hdr.sgml : 20170502 20170502170508 ACCESSION NUMBER: 0000899243-17-011447 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170428 FILED AS OF DATE: 20170502 DATE AS OF CHANGE: 20170502 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Apptio Inc CENTRAL INDEX KEY: 0001419625 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 261175252 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 11100 NE 8TH STREET STREET 2: SUITE 600 CITY: BELLEVUE STATE: WA ZIP: 98004 BUSINESS PHONE: 425-453-5861 MAIL ADDRESS: STREET 1: 11100 NE 8TH STREET STREET 2: SUITE 600 CITY: BELLEVUE STATE: WA ZIP: 98004 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Greylock XII-A Limited Partnership CENTRAL INDEX KEY: 0001496057 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37885 FILM NUMBER: 17805984 BUSINESS ADDRESS: STREET 1: 40 GROVE STREET STREET 2: SUITE 430 CITY: WELLESLEY STATE: MA ZIP: 02482 BUSINESS PHONE: 781-622-2200 MAIL ADDRESS: STREET 1: 40 GROVE STREET STREET 2: SUITE 430 CITY: WELLESLEY STATE: MA ZIP: 02482 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Greylock XII Limited Partnership CENTRAL INDEX KEY: 0001413950 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37885 FILM NUMBER: 17805985 BUSINESS ADDRESS: STREET 1: 40 GROVE STREET STREET 2: SUITE 430 CITY: WELLESLEY STATE: MA ZIP: 02482 BUSINESS PHONE: 781-622-2200 MAIL ADDRESS: STREET 1: 40 GROVE STREET STREET 2: SUITE 430 CITY: WELLESLEY STATE: MA ZIP: 02482 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Greylock XII GP LLC CENTRAL INDEX KEY: 0001413877 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37885 FILM NUMBER: 17805986 BUSINESS ADDRESS: STREET 1: 40 GROVE STREET STREET 2: SUITE 430 CITY: WELLESLEY STATE: MA ZIP: 02482 BUSINESS PHONE: 781-622-2200 MAIL ADDRESS: STREET 1: 40 GROVE STREET STREET 2: SUITE 430 CITY: WELLESLEY STATE: MA ZIP: 02482 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-04-28 0 0001419625 Apptio Inc APTI 0001413877 Greylock XII GP LLC 2550 SAND HILL ROAD, SUITE 200 MENLO PARK CA 94025 0 0 1 0 0001413950 Greylock XII Limited Partnership 2550 SAND HILL ROAD, SUITE 200 MENLO PARK CA 94025 0 0 1 0 0001496057 Greylock XII-A Limited Partnership 2550 SAND HILL ROAD, SUITE 200 MENLO PARK CA 94025 0 0 1 0 Class A Common Stock 2017-04-28 4 S 0 1710000 12.80 D 2708897 I By Greylock XII Limited Partnership Class A Common Stock 2017-04-28 4 S 0 190000 12.80 D 300986 I By Greylock XII-A Limited Partnership On March 22, 2017, Greylock XII Limited Partnership ("Greylock XII LP") received 10,753 shares of the Issuer's Class A Common Stock and Greylock XII-A Limited Partnership ("Greylock XII-A LP") received 1,193 shares of the Issuer's Class A Common Stock in a pro rata distribution in kind from an unaffiliated venture capital fund in which each of Greylock XII LP and Greylock XII-A LP has a passive limited partner interest. Such pro rata distribution in kind was exempt from Section 16 of the Securities Exchange Act of 1934, as amended, pursuant to Rules 16a-13 and 16a-9 promulgated thereunder. The shares are held directly by Greylock XII Limited Partnership ("Greylock XII LP"). Greylock XII GP Limited Liability Company ("Greylock XII GP") is the sole General Partner of Greylock XII LP and may be deemed to share voting and dispositive power with respect to the shares held by Greylock XII LP. Greylock XII GP disclaims beneficial ownership of the securities held by Greylock XII LP except to the extent of any pecuniary interest therein and the inclusion of these securities in this report shall not be deemed an admission by Greylock XII GP of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. The shares are held directly by Greylock XII-A Limited Partnership ("Greylock XII-A LP"). Greylock XII GP is the sole General Partner of Greylock XII-A LP and may be deemed to share voting and dispositive power with respect to the shares held by Greylock XII-A LP. Greylock XII GP disclaims beneficial ownership of the securities held by Greylock XII-A LP except to the extent of any pecuniary interest therein and the inclusion of these securities in this report shall not be deemed an admission by Greylock XII GP of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. /s/ Donald A. Sullivan, as Administrative Partner of Greylock XII GP LLC 2017-05-02 /s/ Donald A. Sullivan, as Administrative Partner of Greylock XII GP LLC, the general partner of Greylock XII Limited Partnership 2017-05-02 /s/ Donald A. Sullivan, as Administrative Partner of Greylock XII GP LLC, the general partner of Greylock XII-A Limited Partnership 2017-05-02