0001540184-15-000004.txt : 20150721 0001540184-15-000004.hdr.sgml : 20150721 20150721120036 ACCESSION NUMBER: 0001540184-15-000004 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150721 DATE AS OF CHANGE: 20150721 EFFECTIVENESS DATE: 20150721 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Medallia Inc. CENTRAL INDEX KEY: 0001540184 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-244115 FILM NUMBER: 15997256 BUSINESS ADDRESS: STREET 1: 395 PAGE MILL ROAD, STE. 100 CITY: PALO ALTO STATE: CA ZIP: 94306 BUSINESS PHONE: (650) 321-3000 MAIL ADDRESS: STREET 1: 395 PAGE MILL ROAD, STE. 100 CITY: PALO ALTO STATE: CA ZIP: 94306 D 1 primary_doc.xml X0707 D LIVE 0001540184 Medallia Inc. 395 PAGE MILL ROAD, # 100 PALO ALTO CA CALIFORNIA 94306 (650) 321-3000 DELAWARE Berrypick, Inc. None Corporation true Borge Hald c/o Medallia, Inc. 395 Page Mill Road, #100 Palo Alto CA CALIFORNIA 94306 Executive Officer Director Amy Pressman c/o Medallia, Inc. 395 Page Mill Road, #100 Palo Alto CA CALIFORNIA 94306 Executive Officer Director Alan Grebene c/o Medallia, Inc. 395 Page Mill Road, #100 Palo Alto CA CALIFORNIA 94306 Executive Officer Mike Kourey c/o Medallia, Inc. 395 Page Mill Road, #100 Palo Alto CA CALIFORNIA 94306 Executive Officer Doug Leone c/o Medallia, Inc. 395 Page Mill Road, #100 Palo Alto CA CALIFORNIA 94306 Director Frank Slootman c/o Medallia, Inc. 395 Page Mill Road, #100 Palo Alto CA CALIFORNIA 94306 Director Steve Walske c/o Medallia, Inc. 395 Page Mill Road, #100 Palo Alto CA CALIFORNIA 94306 Director Stan Meresman c/o Medallia, Inc. 395 Page Mill Road, #100 Palo Alto CA CALIFORNIA 94306 Director Leslie Kilgore c/o Medallia, Inc. 395 Page Mill Road, #100 Palo Alto CA CALIFORNIA 94306 Director Other Technology Decline to Disclose 06b false 2015-07-02 false true true Series E Preferred Stock and underlying shares of Common Stock. false 0 150332172 150332172 0 false 8 0 0 0 false Medallia Inc. /s/ Alan Grebene Alan Grebene VP and General Counsel 2015-07-21