0000899243-19-004323.txt : 20190220 0000899243-19-004323.hdr.sgml : 20190220 20190220204139 ACCESSION NUMBER: 0000899243-19-004323 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181016 FILED AS OF DATE: 20190220 DATE AS OF CHANGE: 20190220 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: O'Grady Standish CENTRAL INDEX KEY: 0001753530 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-38698 FILM NUMBER: 19620305 MAIL ADDRESS: STREET 1: 50 HAWTHORNE STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94107 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Anaplan, Inc. CENTRAL INDEX KEY: 0001540755 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 270897861 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 50 HAWTHORNE STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: 415-742-8199 MAIL ADDRESS: STREET 1: 50 HAWTHORNE STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94105 4/A 1 doc4a.xml FORM 4/A SUBMISSION X0306 4/A 2018-10-16 2018-10-18 0 0001540755 Anaplan, Inc. PLAN 0001753530 O'Grady Standish C/O ANAPLAN, INC. 50 HAWTHORNE STREET SAN FRANCISCO 94105 1 0 1 0 Common Stock 2018-10-16 4 C 0 8179 A 68848 I By Trust Series A Convertible Preferred Stock 2018-10-16 4 C 0 8179 D Common Stock 8179 0 I By Trust The total represents shares received upon conversion of shares of Series A Convertible Preferred Stock held by the Trust (as defined below). On October 18, 2018, the Reporting Person filed a Form 4 which inadvertently omitted the conversion of 8,179 shares of Series A Convertible Preferred Stock held by the Trust in connection with the Initial Public Offering of the Issuer. The shares are held by Standish H. O'Grady and Anne Brophy O'Grady, Trustees of The O'Grady Revocable Trust, dated January 3, 2014 (the "Trust"). The reported security converted into the Issuer's Common Stock on a 1-for-1 basis automatically immediately prior to the closing of the Issuer's initial public offering without payment of further consideration. The shares have no expiration date. /s/ Standish O'Grady 2019-02-20