Filing Details

Accession Number:
0001209191-16-133997
Form Type:
4
Zero Holdings:
No
Publication Time:
2016-07-26 19:54:50
Reporting Period:
2016-07-26
Filing Date:
2016-07-26
Accepted Time:
2016-07-26 19:54:50
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1114995 Impinj Inc PI Electronic Components, Nec (3679) 912041398
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1184752 A Tom Alberg 999 Third Avenue
34Th Floor
Seattle WA 98104
Yes No No No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2016-07-26 672,895 $0.00 672,895 No 4 C Indirect See footnote
Common Stock Acquisiton 2016-07-26 515,242 $0.00 1,188,137 No 4 C Indirect See footnote
Common Stock Acquisiton 2016-07-26 37,028 $9.32 1,225,165 No 4 X Indirect See footnote
Common Stock Disposition 2016-07-26 24,646 $14.00 1,200,519 No 4 F Indirect See footnote
Common Stock Acquisiton 2016-07-26 35,714 $14.00 35,714 No 4 P Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Indirect See footnote
No 4 C Indirect See footnote
No 4 X Indirect See footnote
No 4 F Indirect See footnote
No 4 P Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series 1 Preferred Stock Disposition 2016-07-26 672,895 $0.00 672,895 $0.00
Common Stock Series 2 Preferred Stock Disposition 2016-07-26 412,203 $0.00 412,203 $0.00
Common Stock Series 2 Preferred Warrant (Right to Buy) Disposition 2016-07-26 29,623 $0.00 29,623 $9.32
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 No 4 C Indirect
0 No 4 C Indirect
0 2017-06-30 No 4 X Indirect
Footnotes
  1. Each share of Series 1 Preferred Stock automatically converted into one share of Common Stock immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
  2. 72,531 of these shares are held of record by Madrona Managing Director Fund, LLC; 541,350 of these shares are held of record by Madrona Venture Fund I-A, L.P.; and 59,014 of these shares are held of record by Madrona Venture Fund I-B, L.P.
  3. Madrona Investment Partners, LLC, as the sole general partner of Madrona Venture Fund I-A, L.P. and Madrona Venture Fund I-B, L.P., may be deemed to beneficially own certain of the shares held of record by Madrona Venture Fund I-A, L.P. and Madrona Venture Fund I-B, L.P. but disclaims beneficial ownership of such shares in which it does not have an actual pecuniary interest. Tom A. Alberg, a member of the board of directors, disclaims beneficial ownership of all shares held of record by Madrona Managing Director Fund, LLC, Madrona Venture Fund I-A, L.P. and Madrona Venture Fund I-B, L.P., in which he does not have an actual pecuniary interest. By virtue of their relationship as affiliated entities who have overlapping general partners and managing directors, Madrona Managing Director Fund, LLC, Madrona Venture Fund I-A, L.P., Madrona Venture Fund I-B, L.P., Madrona Investment Partners, LLC and Mr. Alberg may be deemed to share voting and investment control of the record shares.
  4. Each share of Series 2 Preferred Stock automatically converted into 1.24996780424983 shares of Common Stock immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
  5. 128,041 of these shares are held of record by Madrona Managing Director Fund, LLC; 955,959 of these shares are held of record by Madrona Venture Fund I-A, L.P.; and 104,137 of these shares are held of record by Madrona Venture Fund I-B, L.P.
  6. The warrant was automatically net exercised immediately prior to the completion of the Issuer's initial public offering of Common Stock.
  7. 132,030 of these shares are held of record by Madrona Managing Director Fund, LLC; 985,756 of these shares are held of record by Madrona Venture Fund I-A, L.P.; and 107,379 of these shares are held of record by Madrona Venture Fund I-B, L.P.
  8. 129,375 of these shares are held of record by Madrona Managing Director Fund, LLC; 965,923 of these shares are held of record by Madrona Venture Fund I-A, L.P.; and 105,221 of these shares are held of record by Madrona Venture Fund I-B, L.P.