X0206 3 2014-03-06 0 0001115128 COUPONS.com Inc COUP 0001601045 Boal Steven R. 400 LOGUE AVENUE MOUNTAIN VIEW CA 94043 1 1 1 0 President and CEO Common Stock 1565191 D Common Stock 500000 I By Steven R. Boal, Trustee of the Michele L. Boal Annuity Trust dated December 6, 2013 Common Stock 500000 I By Steven R. Boal, Trustee of the Steven R. Boal Annuity Trust dated December 6, 2013 Common Stock 3237 I by Stuart Shiff, Trustee of the EBB 2011 TRUST dated September 23, 2011 Common Stock 3237 I by Stuart Shiff, Trustee of the JMB 2011 TRUST dated September 23, 2011 Common Stock 3237 I by Stuart Shiff, Trustee of the SEB 2011 TRUST dated September 23, 2011 Series 1 Preferred Stock (Convertible) 0.63 Common Stock 3653938 D Employee Stock Option (right to buy) 0.2688 2014-11-12 Common Stock 63256 D Employee Stock Option (right to buy) 0.2688 2017-01-18 Common Stock 240000 D Employee Stock Option (right to buy) 3.675 2021-04-17 Common Stock 160000 D Employee Stock Option (right to buy) 5.325 2022-02-06 Common Stock 200000 D Employee Stock Option (right to buy) 3.70 2023-02-06 Common Stock 240000 D Employee Stock Option (right to buy) 8.65 2023-11-13 Common Stock 600000 D Employee Stock Option (right to buy) 16.25 2023-11-13 Common Stock 600000 D Employee Stock Option (right to buy) 25.00 2023-11-13 Common Stock 800000 D Each share will automatically convert into one share of Common Stock immediately prior to the closing of the Issuer's initial public offering. Not applicable. Options were granted on 11/12/2004, are fully vested, immediately exerciseable and expire on 11/12/2014. Options were granted on 1/19/2007, are fully vested, immediately exerciseable and expire on 1/18/2017. Subject to the Reporting Person's continued service to the Issuer, 25% of the shares underlying the options vested on the one-year anniversary of 4/18/2011, and thereafter 1/48th of the shares vest monthly and become 100% exercisable on 4/18/2015. Subject to the Reporting Person's continued service to the Issuer, 25% of the shares underlying the options vested on the one-year anniversary of 2/07/2012, and thereafter 1/48th of the shares vest monthly and become 100% exercisable on 2/07/2016. Subject to the Reporting Person's continued service to the Issuer, 25% of the shares underlying the options vest on the one-year anniversary of 2/07/2013, and thereafter 1/48th of the shares vest monthly and become 100% exercisable on 2/07/2017. Subject to the Reporting Person's continued service to the Issuer, 25% of the shares underlying the options vest on the one-year anniversary of 11/14/2013, and thereafter 1/48th of the shares vest monthly and become 100% exercisable on 11/14/2017. /s/ Richard Hornstein, as Power of Attorney on behalf of Steven R. Boal 2014-03-06