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