Statement of Changes in Beneficial Ownership (4)
May 29 2020 - 4:31PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
*
van Veenendaal Frank |
2. Issuer Name and Ticker or Trading Symbol
Coupa Software Inc
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COUP
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O COUPA SOFTWARE INC., 1855 S. GRANT STREET |
3. Date of Earliest Transaction
(MM/DD/YYYY)
5/27/2020 |
(Street)
SAN MATEO, CA 94402
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 5/28/2020 | | M | | 1710 | A | $0 | 71329 | D | |
Common Stock | | | | | | | | 31603 | I | By trust (1) |
Common Stock | | | | | | | | 31603 | I | By trust (1) |
Common Stock | | | | | | | | 36500 | I | By trust (2) |
Common Stock | 5/28/2020 | | G(3) | | 1000 | D | $0 | 70329 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Resetricted Stock Unit | $0 (4) | 5/27/2020 | | A | | 930 | | (5) | (5) | Common Stock | 930 | $0 | 930 | D | |
Restricted Stock Unit | $0 (4) | 5/28/2020 | | M | | | 1710 | (5) | (5) | Common Stock | 1710 | $0 | 0 | D | |
Explanation of Responses: |
(1) | Shares held in a grantor retained annuity trust (GRAT). |
(2) | Shares held in a revocable trust. |
(3) | Irrevocable Gift to Donor Advised Fund. |
(4) | Each Restricted Stock Unit converts into common stock on a one-for-one basis. |
(5) | These RSUs vested in full upon the earlier of (i) the one-year anniversary of the date of grant or (ii) the date of the regular annual meeting of the Issuer's stockholders held in the year following the date of grant. Vested shares were delivered to the reporting person upon vest date. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
van Veenendaal Frank C/O COUPA SOFTWARE INC. 1855 S. GRANT STREET SAN MATEO, CA 94402 | X |
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Signatures
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/s/ Jon Stueve, Authorized Signatory For: Frank van Veenendaal | | 5/29/2020 |
**Signature of Reporting Person | Date |
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