Statement of Changes in Beneficial Ownership (4)
June 02 2020 - 5:18PM
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
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O'Driscoll Rory |
2. Issuer Name and Ticker or Trading Symbol
Bill.com Holdings, Inc.
[
BILL
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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 BILL.COM HOLDINGS, INC., 1810 EMBARCADERO ROAD |
3. Date of Earliest Transaction
(MM/DD/YYYY)
6/1/2020 |
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(Street)
PALO ALTO, CA 94306
(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 | 6/1/2020 | | J(1) | | 22645 | D | $0.00 | 0 | I | See Footnote (2) |
| Common Stock | 6/1/2020 | | J(1) | | 5820 | A | $0.00 | 5820 | I | See Footnote (3) |
| Common Stock | | | | | | | | 1250 | D | |
| Common Stock | | | | | | | | 2641927 | I | See Footnote (4) |
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 |
| Explanation of Responses: |
| (1) | The shares reported on this form represent pro rata distributions, and not sales or purchases, of securities by the reporting entity to its partners or members or the funds for which it acts as nominee without consideration. |
| (2) | The shares were held by Scale Venture Management IV, LP ("ScaleVM LP). The general partner of ScaleVM LP is ScaleVM LLC. Rory O'Driscoll, a member of the Issuer's board of directors, Stacey Bishop, and Andrew Vitus are managers of ScaleVM LLC and share voting and dispositive power with respect to shares held by ScaleVM LP. |
| (3) | The shares are held by a trust for which the reporting person serves as a trustee. |
| (4) | The shares are held by Scale Venture Partners IV, L.P. ("ScaleVP LP"). Scale Venture Management IV, LLC ("ScaleVM LLC") is the ultimate general partner of ScaleVP LP. Rory O'Driscoll, a member of the Issuer's board of directors, Stacey Bishop, and Andrew Vitus are managers of ScaleVM LLC and share voting and dispositive power with respect to the shares held by ScaleVP LP. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
O'Driscoll Rory
C/O BILL.COM HOLDINGS, INC.
1810 EMBARCADERO ROAD
PALO ALTO, CA 94306 | X |
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Signatures
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| /s/ Rajesh Aji, Attorney-in-Fact | | 6/2/2020 |
| **Signature of Reporting Person | Date |
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