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Filing Details

Accession Number:: 0001140361-13-013859
Form Type:: 4
Zero Holdings:: No
Publication Time:: 2013-03-25 16:13:00
Reporting Period:: 2013-03-25

Filing Date:: 2013-03-25
Accepted Time:: 2013-03-25 16:13:00
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	Director	Officer	Large Shareholder	Other
1474979	Akkr Management Company, Llc	C/O Accel-Kkr 2500 Sand Hill Road, Suite 300 Menlo Park CA 94025	No	No	Yes	No
1474980	Thomas Barnds	C/O Accel-Kkr 2500 Sand Hill Road, Suite 300 Menlo Park CA 94025	No	No	Yes	No
1475179	Robert Palumbo	C/O Accel-Kkr 2500 Sand Hill Road, Suite 300 Menlo Park CA 94025	No	No	Yes	No
1572373	Accel-Kkr Internet Co Llc	C/O Accel-Kkr 2500 Sand Hill Road, Suite 300 Menlo Park CA 94025	No	No	Yes	No

Reported Non-Derivative Transactions

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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	Indirect	See Footnotes
Common Stock	Acquisiton	2013-03-25	391,811	$0.00	1,867,737	No	4	C	Indirect	See Footnotes
Common Stock	Disposition	2013-03-25	740,000	$14.42	1,127,737	No	4	S	Indirect	See Footnotes

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	C	Indirect	See Footnotes
No	4	C	Indirect	See Footnotes
No	4	S	Indirect	See Footnotes

Reported Derivative Transactions

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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	Indirect
0			No	4	C	Indirect

Footnotes

Accel-KKR Company LLC is the record owner of the common stock of Model N, Inc. (the "Issuer"). In connection with the Issuer's 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.
Accel-KKR Company LLC is the record owner of the common stock of the Issuer. 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.
Accel-KKR Internet Company LLC is the managing member of Accel-KKR Company LLC and AKKR Management Company, LLC is the manager of Accel-KKR Internet Company LLC. The managing members of AKKR Management Company, LLC are Thomas C. Barnds and Robert A. Palumbo. Each of Accel-KKR Internet Company LLC, AKKR Management Company, LLC, Mr. Barnds and Mr. Palumbo may be deemed to share voting and dispositive power with respect to the shares held of record by Accel-KKR Company LLC. Each reporting person disclaims beneficial ownership of such securities except to the extent of such person's pecuniary interest therein.
The record owner of the reported securities has separately filed a Form 4.
None.