Statement of Changes in Beneficial Ownership (4)
August 15 2018 - 6:42PM
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).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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
*
DUNLEVIE BRUCE
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2. Issuer Name
and
Ticker or Trading Symbol
SERVICESOURCE INTERNATIONAL, INC.
[
SREV
]
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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 BENCHMARK CAPITAL PARTNERS, 2965 WOODSIDE ROAD
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3. Date of Earliest Transaction
(MM/DD/YYYY)
8/13/2018
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(Street)
WOODSIDE, CA 94062
(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
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8/13/2018
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P
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6956
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A
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$3.15
(1)
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242575
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I
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See footnote
(2)
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Common Stock
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8/14/2018
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P
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46615
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A
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$3.07
(3)
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289190
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I
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See footnote
(2)
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Common Stock
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8/15/2018
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P
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30335
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A
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$2.98
(4)
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319525
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I
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See footnote
(2)
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Common Stock
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141182
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D
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Common Stock
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68627
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I
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See footnote
(5)
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Common Stock
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4476535
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I
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See footnote
(6)
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Common Stock
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545811
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I
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See footnote
(7)
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Common Stock
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104503
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I
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See footnote
(8)
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Common Stock
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82232
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I
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See footnote
(9)
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Common Stock
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5850740
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I
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See footnote
(10)
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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)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Explanation of Responses:
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(1)
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The shares were purchased in multiple trades during the day at prices ranging from $3.13 to $3.18, inclusive. The weighted-average price is reported above. The reporting person hereby undertakes to provide upon request, to the SEC staff, the Issuer or a security holder of the Issuer, full information regarding the number of shares and prices at which the transactions were effected.
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(2)
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Shares are owned directly by Bruce W. Dunlevie's family trust.
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(3)
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The shares were purchased in multiple trades during the day at prices ranging from $2.98 to $3.15, inclusive. The weighted-average price is reported above. The reporting person hereby undertakes to provide upon request, to the SEC staff, the Issuer or a security holder of the Issuer, full information regarding the number of shares and prices at which the transactions were effected.
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(4)
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The shares were purchased in multiple trades during the day at prices ranging from $2.91 to $3.01, inclusive. The weighted-average price is reported above. The reporting person hereby undertakes to provide upon request, to the SEC staff, the Issuer or a security holder of the Issuer, full information regarding the number of shares and prices at which the transactions were effected.
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(5)
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Shares are owned directly by a limited liability company controlled by Bruce W. Dunlevie.
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(6)
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Shares are owned directly by Benchmark Capital Partners V, L.P. ("BCP V").
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(7)
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Shares are owned directly by Benchmark Founders' Fund V, L.P. ("BFF V").
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(8)
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Shares are owned directly by Benchmark Founders' Fund V-A L.P. ("BFF V-A").
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(9)
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Shares are owned directly by Benchmark Founders' Fund V-B, L.P. ("BFF V-B").
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(10)
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Benchmark Capital Management Co. V, L.L.C. ("BCMC V"), the general partner of each of BCP V, BFF V, BFF V-A and BFF V-B, may be deemed to have sole voting and dispositive power over these shares. BCMC V and each of its managing members disclaim beneficial ownership of these shares except to the extent of any pecuniary interest therein, and the filing of this report is not an admission that BCMC V and it managing members are the beneficial owner of these shares for purposes of Section 16 or any other purpose.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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DUNLEVIE BRUCE
C/O BENCHMARK CAPITAL PARTNERS
2965 WOODSIDE ROAD
WOODSIDE, CA 94062
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X
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Signatures
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/s/ Patricia A. Elias, by power of attorney
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8/15/2018
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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