0001209191-21-052104.txt : 20210817 0001209191-21-052104.hdr.sgml : 20210817 20210817204827 ACCESSION NUMBER: 0001209191-21-052104 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210815 FILED AS OF DATE: 20210817 DATE AS OF CHANGE: 20210817 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Pressman Amy E CENTRAL INDEX KEY: 0001782198 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38982 FILM NUMBER: 211184796 MAIL ADDRESS: STREET 1: C/O MEDALLIA INC STREET 2: 575 MARKET STREET SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hald Borge CENTRAL INDEX KEY: 0001782199 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38982 FILM NUMBER: 211184797 MAIL ADDRESS: STREET 1: C/O MEDALLIA INC STREET 2: 575 MARKET STREET SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Medallia, Inc. CENTRAL INDEX KEY: 0001540184 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 575 MARKET STREET STREET 2: SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: (650) 321-3000 MAIL ADDRESS: STREET 1: 575 MARKET STREET STREET 2: SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 FORMER COMPANY: FORMER CONFORMED NAME: Medallia Inc. DATE OF NAME CHANGE: 20120123 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-08-15 0 0001540184 Medallia, Inc. MDLA 0001782199 Hald Borge C/O MEDALLIA, INC. 575 MARKET STREET, SUITE 1850 SAN FRANCISCO CA 94105 1 0 0 0 0001782198 Pressman Amy E C/O MEDALLIA, INC. 575 MARKET STREET, SUITE 1850 SAN FRANCISCO CA 94105 1 0 0 0 Common Stock 2021-08-15 4 A 0 298 0.00 A 2054200 I See footnote Common Stock 1532592 D Common Stock 1731023 I See footnote Common Stock 1590289 I See footnote The reported shares are represented by restricted stock units, or RSUs, all of which were vested on the award date. The shares are held of record by Ms. Pressman. The reporting persons are husband and wife. The shares are held of record by the Borge Hald Irrevocable Trust U/A/D 11/4/2019 First Republic Trust Company of Delaware LLC, Trustee for which Mr. Hald serves as an investment advisor. The shares are held of record by the Amy Hald Irrevocable Trust U/A/D 11/4/2019 First Republic Trust Company of Delaware LLC, Trustee for which Ms. Pressman serves as an investment advisor. /s/ Katheryn Delor, by power of attorney for Borge C. Hald 2021-08-17 /s/ Katheryn Delor, by power of attorney for Amy E. Pressman 2021-08-17