X0306 4 2017-09-11 0 0001090908 DETERMINE, INC. DTRM 0000949119 MILLER LLOYD I III 3300 SOUTH DIXIE HIGHWAY SUITE 1-365 WEST PALM BEACH FL 33405 0 0 1 0 Common Stock 839575 I By Trust A-4 - Lloyd I. Miller Common Stock 250820 D Common Stock 1353315 I By Milfam II L.P. Common Stock 334590 I By Trust C - Lloyd I. Miller Common Stock 2100 I By Trust D - Lloyd I. Miller Common Stock 211351 I By Milfam I L.P. Junior Secured Convertible Promissory Note 3.00 2016-12-27 2021-12-27 Common Stock 333333 333333 I By Milfam II L.P. PIK Interest on Junior Secured Convertible Promissory Note 3.00 2016-12-27 2021-12-27 Common Stock 20652 20652 I By Milfam II L.P. Junior Secured Convertible Promissory Note 3.00 2015-12-16 2020-12-16 Common Stock 200000 200000 D PIK Interest on Junior Secured Convertible Promissory Note 3.00 2015-12-16 2020-12-16 Common Stock 15377 15377 D Junior Secured Convertible Promissory Note 3.00 2015-12-16 2020-12-16 Common Stock 200000 200000 I By Milfam II L.P. PIK Interest on Junior Secured Convertible Promissory Note 3.00 2015-12-16 2020-12-16 Common Stock 15377 15377 I By Milfam II L.P. Junior Secured Convertible Promissory Note 3.00 2015-12-16 2020-12-16 Common Stock 200000 200000 I By Trust A-4 - Lloyd I. Miller PIK Interest on Junior Secured Convertible Promissory Note 3.00 2015-12-16 2020-12-16 Common Stock 15377 15377 I By Trust A-4 - Lloyd I. Miller Junior Secured Convertible Promissory Notes 5.70 2020-12-16 Common Stock 132015 132015 I By Milfam II L.P. PIK Interest on Junior Secured Convertible Promissory Note 5.70 2017-09-11 4 J 0 20437.42 A 2020-12-16 Common Stock 3585 3585 I By Milfam II L.P. Junior Secured Convertible Promissory Notes 5.70 2020-12-16 Common Stock 132015 132015 D PIK Interest on Junior Secured Convertible Promissory Note 5.70 2017-09-11 4 J 0 20437.37 A 2020-12-16 Common Stock 3585 3585 D Junior Secured Convertible Promissory Notes 5.70 2020-12-16 Common Stock 132015 132015 I By Trust A-4 - Lloyd I. Miller PIK Interest on Junior Secured Convertible Promissory Note 5.70 2017-09-11 4 J 0 20437.37 A 2020-12-16 Common Stock 3585 3585 I By Trust A-4 - Lloyd I. Miller Additional Extension Payment Shares Common Stock 10417 10417 D Additional Extension Payment Shares Common Stock 10417 10417 I By Milfam II L.P. Warrant 6.00 Common Stock 79787 79787 I By Milfam I L.P. Warrant 6.00 Common Stock 79787 79787 I By Milfam II L.P. Warrant 6.00 Common Stock 79787 79787 I By Trust C - Lloyd I. Miller Warrant 7.00 2014-08-27 2019-08-27 Common Stock 49401 49401 I By Trust A-4 - Lloyd I. Miller Warrant 7.00 2014-08-27 2019-08-27 Common Stock 13722 13722 I By Trust C - Lloyd I. Miller Warrant 7.00 2014-08-27 2019-08-27 Common Stock 74102 74102 I By Milfam II L.P. Warrant 7.00 2014-07-24 2019-07-24 Common Stock 57558 57558 I By Trust A-4 - Lloyd I. Miller Warrant 7.00 2014-07-24 2019-07-24 Common Stock 15988 15988 I By Trust C - Lloyd I. Miller Warrant 7.00 2014-07-24 2019-07-24 Common Stock 86338 86338 I By Milfam II L.P. Series A Warrant 7.75 2013-12-01 2018-05-31 Common Stock 40894 40894 I By Trust A-4 - Lloyd I. Miller Series A Warrant 7.75 2013-12-01 2018-05-31 Common Stock 11359 11359 I By Trust C - Lloyd I. Miller Series A Warrant 7.75 2013-12-01 2018-05-31 Common Stock 61342 61342 I By Milfam II L.P. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. This filing shall not be deemed an admission that the reporting person is, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the beneficial owner of any equity securities covered by this filing. At the election of the Issuer, the quarterly interest payment has been paid as paid-in-kind interest compounded to the original principal amount of the Note. Includes all previously reported PIK Interest on Junior Secured Convertible Promissory Note As previously reported, the issuer entered into a binding term sheet with the reporting person pursuant to which the issuer agreed to issue and the reporting person agreed to purchase, junior secured convertible promissory notes in the aggregate principal amount of $3 million subject to negotiation and execution of definitive documentation. On March 11, 2015, the notes were executed and on May 5, 2015, the shareholders approved the conversion of the notes at the stockholders meeting. Subject to adjustment for fractional shares. Pursuant to the Guaranty Fee Agreement, in the event that the maturity date of April 30, 2019 is extended, which extended termination date shall be no later than July 30, 2020, the Issuer agrees to pay Lloyd I. Miller, III and Milfam II L.P. the shares of common stock referenced herein. Such Warrant will be exercisable six months following the date of issuance, February 6, 2015. Such Warrant will expire on the fifth anniversary of the exercisability date. /s/ Paul N. Silverstein Attorney-in-fact 2017-09-13