SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Woodhams Mark

(Last) (First) (Middle)
21300 VICTORY BLVD., 12TH FLOOR

(Street)
WOODLAND HILLS CA 91367

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/01/2021
3. Issuer Name and Ticker or Trading Symbol
BLACKLINE, INC. [ BL ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Revenue Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 28,569(1) D
Common Stock 9,079(2) D
Common Stock 17,540(3) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) (4) 08/07/2028 Common Stock 135,760 49.04 D
Stock Option (right to buy) (5) 05/15/2029 Common Stock 33,900 48.65 D
Stock Option (right to buy) (6) 04/15/2030 Common Stock 38,160 57.11 D
Explanation of Responses:
1. Each share is represented by a restricted stock unit ("RSU"). 25% of the RSUs vested on August 20, 2019 and 1/16th of the RSUs will vest every three months thereafter, subject to the Reporting Person's continued service through the applicable vesting date.
2. Each share is represented by a restricted stock unit ("RSU"). 25% of the RSUs vested on February 20, 2020 and 1/16th of the RSUs will vest every three months thereafter, subject to the Reporting Person's continued service through the applicable vesting date.
3. Each share is represented by a restricted stock unit ("RSU"). 25% of the RSUs will vest on February 20, 2021 and 1/16th of the RSUs will vest every three months thereafter, subject to the Reporting Person's continued service through the applicable vesting date.
4. 25% of the options vested on August 20, 2019 and 1/16th of the remaining shares subject to the option will vest every three months thereafter, subject to the Reporting Person's continued service through the applicable vesting date.
5. 25% of the options vested on February 20, 2020 and 1/16th of the remaining shares subject to the option will vest every three months thereafter, subject to the Reporting Person's continued service through the applicable vesting date.
6. 25% of the options will vest on May 20, 2021 and 1/16th of the remaining shares subject to the option will vest every three months thereafter, subject to the Reporting Person's continued service through the applicable vesting date.
Remarks:
/s/ Karole Morgan-Prager, Attorney-in-Fact 01/07/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.