0001628280-21-011625.txt : 20210603 0001628280-21-011625.hdr.sgml : 20210603 20210603172730 ACCESSION NUMBER: 0001628280-21-011625 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210602 FILED AS OF DATE: 20210603 DATE AS OF CHANGE: 20210603 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KEARL JEFF CENTRAL INDEX KEY: 0001521855 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38553 FILM NUMBER: 21993686 MAIL ADDRESS: STREET 1: C/O SKULLCANDY, INC. STREET 2: 1441 WEST UTE BLVD., SUITE 250 CITY: PARK CITY STATE: UT ZIP: 84908 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DOMO, INC. CENTRAL INDEX KEY: 0001505952 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 273687433 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 772 EAST UTAH VALLEY DRIVE CITY: AMERICAN FORK STATE: UT ZIP: 84003 BUSINESS PHONE: 801-899-1000 MAIL ADDRESS: STREET 1: 772 EAST UTAH VALLEY DRIVE CITY: AMERICAN FORK STATE: UT ZIP: 84003 FORMER COMPANY: FORMER CONFORMED NAME: LIGHTSTORM, INC. DATE OF NAME CHANGE: 20110425 FORMER COMPANY: FORMER CONFORMED NAME: SHACHO, INC. DATE OF NAME CHANGE: 20101117 4 1 wf-form4_162275561556712.xml FORM 4 X0306 4 2021-06-02 0 0001505952 DOMO, INC. DOMO 0001521855 KEARL JEFF C/O DOMO, INC. 772 UTAH VALLEY DRIVE AMERICAN FORK UT 84003 1 0 0 0 Class B Common Stock 2021-06-02 4 A 0 2257 0 A 24415 D Class B Common Stock 2348 I Held by Pura Vida Investment Capital LLC The shares are represented by restricted stock units (each, an "RSU"). Each RSU represents the Reporting Person's right to receive one share of Class B Common Stock of the Issuer, subject to the applicable vesting schedule. In the event the Reporting Person ceases to be a service provider, the unvested RSUs will be canceled by the Issuer. Daniel Stevenson, attorney-in-fact 2021-06-03