Filing Details

Accession Number:
0001140361-13-013858
Form Type:
4
Zero Holdings:
No
Publication Time:
2013-03-25 16:12:16
Reporting Period:
2013-03-25
Filing Date:
2013-03-25
Accepted Time:
2013-03-25 16:12:16
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1118417 Model N Inc. MODN Services-Computer Programming, Data Processing, Etc. (7370) 770528806
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1572372 Accel-Kkr Co Llc 2500 Sand Hill Road, Suite 300
Menlo Park CA 94025
No No Yes 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 2013-03-25 1,475,926 $0.00 1,475,926 No 4 C Direct
Common Stock Acquisiton 2013-03-25 391,811 $0.00 1,867,737 No 4 C Direct
Common Stock Disposition 2013-03-25 740,000 $14.42 1,127,737 No 4 S Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Direct
No 4 C Direct
No 4 S Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series B Preferred Stock Disposition 2013-03-25 3,714,284 $0.00 1,475,926 $0.00
Common Stock Series C Preferred Stock Disposition 2013-03-25 1,175,433 $0.00 391,811 $0.00
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 No 4 C Direct
0 No 4 C Direct
Footnotes
  1. In connection with Model N, Inc.'s (the "Issuer") initial public offering of common stock on March 25, 2013, each share of Series B Preferred Stock automatically converted into 0.397365 shares of the Issuer's common stock for no additional consideration reflecting an adjustment following the one-for-three reverse stock split effectuated by the Issuer on February 26, 2013. All shares of common stock, including fractions thereof, issued upon conversion were aggregated. No fractional share was issued upon conversion of any shares of any series of preferred stock.
  2. In connection with the Issuer's initial public offering of common stock on March 25, 2013, each share of Series C Preferred Stock automatically converted into one-third shares of the Issuer's common stock for no additional consideration reflecting an adjustment following the one-for-three reverse stock split effectuated by the Issuer on February 26, 2013. All shares of common stock, including fractions thereof, issued upon conversion were aggregated. No fractional share was issued upon conversion of any shares of any series of preferred stock.
  3. None.