Statement of Changes in Beneficial Ownership (4)
June 22 2022 - 06:53PM
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 * BERNSHTEYN
ROBERT |
2. Issuer Name and Ticker or Trading
Symbol Coupa Software Inc [ COUP ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Chief Executive Officer |
(Last)
(First)
(Middle)
C/O COUPA SOFTWARE INC., 1855 S. GRANT STREET |
3. Date of Earliest Transaction (MM/DD/YYYY)
6/20/2022
|
(Street)
SAN MATEO, CA 94402
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
6. Individual or Joint/Group Filing
(Check Applicable Line) _X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
6/20/2022 |
|
M |
|
14729 |
A |
$0 |
253696 |
D |
|
Common Stock |
6/21/2022 |
|
S |
|
8076 |
D |
$55.1055 (1) |
245620 |
D |
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
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 |
Restricted Stock Units |
(2) |
6/20/2022 |
|
M |
|
|
4731 |
(3) |
(3) |
Common Stock |
4731 |
$0 |
14193 |
D |
|
Restricted Stock Units |
(2) |
6/20/2022 |
|
M |
|
|
2652 |
(4) |
(4) |
Common Stock |
2652 |
$0 |
18562 |
D |
|
Restricted Stock Units |
(2) |
6/20/2022 |
|
M |
|
|
1659 |
(5) |
(5) |
Common Stock |
1659 |
$0 |
18243 |
D |
|
Restricted Stock Units |
(2) |
6/20/2022 |
|
M |
|
|
5687 |
(6) |
(6) |
Common Stock |
5687 |
$0 |
85313 |
D |
|
Explanation of
Responses: |
(1) |
As previously disclosed,
these shares of common stock were automatically sold to satisfy the
reporting person's tax withholding obligations in a
non-discretionary transaction. |
(2) |
Each Restricted Stock Unit
converts into common stock on a one-for-one basis. |
(3) |
These RSUs vest quarterly
over a four year period, and the first quarterly vesting occurred
on June 20, 2019. Vested shares will be delivered to the reporting
person upon vest date. Unless otherwise provided, on each vest date
shares of common stock will automatically be sold to satisfy the
reporting person's tax withholding obligations in a
non-discretionary transaction. |
(4) |
These RSUs vest quarterly
over a four year period, and the first quarterly vesting occurred
on June 20, 2020. Vested shares will be delivered to the reporting
person upon vest date. Unless otherwise provided, on each vest date
shares of common stock will automatically be sold to satisfy the
reporting person's tax withholding obligations in a
non-discretionary transaction. |
(5) |
These RSUs vest quarterly
over a four year period, and the first quarterly vesting occurred
on June 20, 2021. Vested shares will be delivered to the reporting
person upon vest date. Unless otherwise provided, on each vest date
shares of common stock will automatically be sold to satisfy the
reporting person's tax withholding obligations in a
non-discretionary transaction. |
(6) |
These RSUs vest quarterly
over a four year period, and the first quarterly vesting occurred
on June 20, 2022. Vested shares will be delivered to the reporting
person upon vest date. Unless otherwise provided, on each vest date
shares of common stock will automatically be sold to satisfy the
reporting person's tax withholding obligations in a
non-discretionary transaction. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
BERNSHTEYN ROBERT
C/O COUPA SOFTWARE INC.
1855 S. GRANT STREET
SAN MATEO, CA 94402 |
X |
|
Chief Executive Officer |
|
Signatures
|
/s/ Jon Stueve, Authorized Signatory For: Robert
Bernshteyn |
|
6/22/2022 |
**Signature
of Reporting Person |
Date |
Reminder: Report on a separate line for each class
of securities beneficially owned directly or
indirectly. |
* |
If the form is filed by more than one
reporting person, see Instruction 4(b)(v). |
** |
Intentional misstatements or omissions
of facts constitute Federal Criminal Violations. See 18
U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: |
File three copies of this Form, one of
which must be manually signed. If space is insufficient, see
Instruction 6 for procedure. |
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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