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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Restricted Stock Unit | (9) | 02/20/2017 | M | 37,500 | (10) | (10) | Common Stock | 37,500 | $ 0 | 37,500 | D | ||||
Restricted Stock Unit | (9) | 02/20/2017 | M | 43,750 | (11) | (11) | Common Stock | 43,750 | $ 0 | 87,500 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Boal Steven R. C/O QUOTIENT TECHNOLOGY INC. 400 LOGUE AVENUE MOUNTAIN VIEW, CA 94043 |
X | CEO |
/s/Margaret Tong Atty-in-Fact for Steven R Boal | 02/23/2017 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The sales reported on this Form 4 were sold by the reporting person pursuant to an Issuer approved "Sales to Cover Plan" in order to cover withholding taxes incident to the vesting of the restricted stock unit. |
(2) | The price reported in column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $11.775 to $12.85, inclusive. The reporting person undertakes to provide Quotient Technology Inc., any security holder of Quotient Technology Inc. or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. |
(3) | These shares are held directly by the SMSEJ Family Trust U/A dated July 18, 2005 of which Mr. Boal is a co-trustee. |
(4) | These shares are held directly by Steven R. Boal TTEE of the Steven R Boal Annuity Trust dated December 6, 2013. |
(5) | These shares are held directly by Steven R. Boal TTEE of the Michelle L. Boal Annuity Trust dated December 6, 2013. |
(6) | These shares are held directly by Stuart Shiff TTEE of the EBB 2011 Trust dated September 23, 2011. |
(7) | These shares are held directly by Stuart Shiff TTEE of the JMB 2011 Trust dated September 23, 2011. |
(8) | These shares are held directly by Stuart Shiff TTEE of the SEB 2011 Trust dated September 23, 2011. |
(9) | The par value of QUOT common stock is $0.00001 per share. |
(10) | 1/4th of the restricted stock unit granted on May 1, 2014 became vested on February 20, 2017 and shares were delivered to reporting person on February 21, 2017. 1/4th of the restricted stock unit will continue to vest annually and shares will be delivered to reporting person on each vest date. |
(11) | 1/4th of the restricted stock unit granted on February 5, 2015 became vested on February 20, 2017 and shares were delivered to reporting person on February 21,2017. 1/4th of the restricted stock unit will continue to vest annually and shares will be delivered to reporting person on each vest date. |