Goux Benjamin J. 4

Accession 0000899243-18-017222

CIK 0001348036other

View on SEC.gov Company Profile

Filed

Jun 18, 8:00 PM ET

Accepted

Jun 19, 6:37 PM ET

Size

78.5 KB

Accession

0000899243-18-017222

Insider Transaction Report

Form 4

Period: 2018-01-24

AVALARA INCAVLR

Goux Benjamin J.

Director

Transactions

Tax Payment
Common Stock
2018-06-14$24.00/sh−4,050$97,200→ 32,680 total
Exercise/Conversion
Common Stock
2018-06-14$13.84/sh+10,000$138,400→ 58,529 total
Exercise/Conversion
Common Stock
2018-06-14$4.50/sh+10,000$45,000→ 28,605 total
Tax Payment
Common Stock
2018-06-14$24.00/sh−1,875$45,000→ 26,730 total
Conversion
Common Stock
2018-06-19+113,635→ 1,391,196 total(indirect: By LLC)
Conversion
Series A Preferred Stock
2018-06-19−1,806,319→ 0 total(indirect: By LLC)
→ Common Stock (903,157 underlying)
Conversion
Series A-1 Preferred Stock
2018-06-19−454,449→ 0 total(indirect: By LLC)
→ Common Stock (227,224 underlying)
Conversion
Series C-1 Preferred Stock
2018-06-19−246,175→ 0 total(indirect: By LLC)
→ Common Stock (123,087 underlying)
Conversion
Common Stock
2018-06-19+60,000→ 1,574,283 total(indirect: By LLC)
Award
Warrant (right to buy)
2018-01-24+10,000→ 10,000 total
Exercise: $16.60→ Common Stock (10,000 underlying)
Other
Warrant (right to buy)
2018-06-11+3,000→ 3,000 total(indirect: By LLC)
Exercise: $16.60→ Common Stock (3,000 underlying)
Exercise/Conversion
Common Stock
2018-06-14$9.16/sh+10,000$91,600→ 42,680 total
Tax Payment
Common Stock
2018-06-14$24.00/sh−4,842$116,208→ 54,920 total
Conversion
Series B Preferred Stock
2018-06-19−288,360→ 0 total(indirect: By LLC)
→ Common Stock (144,180 underlying)
Conversion
Series B-1 Preferred Stock
2018-06-19−227,272→ 0 total(indirect: By LLC)
→ Common Stock (113,635 underlying)
Tax Payment
Common Stock
2018-06-14$24.00/sh−3,817$91,608→ 38,863 total
Exercise/Conversion
Common Stock
2018-06-14$12.20/sh+10,000$122,000→ 48,863 total
Tax Payment
Common Stock
2018-06-14$24.00/sh−5,084$122,016→ 43,779 total
Tax Payment
Common Stock
2018-06-14$24.00/sh−5,250$126,000→ 48,529 total
Tax Payment
Common Stock
2018-06-14$24.00/sh−5,767$138,408→ 52,762 total
Exercise/Conversion
Common Stock
2018-06-14$16.60/sh+7,000$116,200→ 59,762 total
Exercise of In-Money
Common Stock
2018-06-11$16.60/sh+3,000$49,800→ 3,000 total(indirect: By LLC)
Conversion
Common Stock
2018-06-19+227,224→ 1,133,381 total(indirect: By LLC)
Other
Warrant (right to buy)
2018-06-11−3,000→ 7,000 total
Exercise: $16.60→ Common Stock (3,000 underlying)
Exercise/Conversion
Warrant (right to buy)
2018-06-14−10,000→ 0 total
Exercise: $4.50→ Common Stock (10,000 underlying)
Exercise/Conversion
Warrant (right to buy)
2018-06-14−10,000→ 0 total
Exercise: $9.16→ Common Stock (10,000 underlying)
Exercise/Conversion
Warrant (right to buy)
2018-06-14−10,000→ 0 total
Exercise: $13.84→ Common Stock (10,000 underlying)
Exercise/Conversion
Common Stock
2018-06-14$9.72/sh+10,000$97,200→ 36,730 total
Exercise/Conversion
Common Stock
2018-06-14$12.60/sh+10,000$126,000→ 53,779 total
Conversion
Common Stock
2018-06-19+144,180→ 1,277,561 total(indirect: By LLC)
Conversion
Common Stock
2018-06-19+123,087→ 1,514,283 total(indirect: By LLC)
Exercise/Conversion
Warrant (right to buy)
2018-06-14−10,000→ 0 total
Exercise: $9.72→ Common Stock (10,000 underlying)
Exercise/Conversion
Warrant (right to buy)
2018-06-14−7,000→ 0 total
Exercise: $16.60→ Common Stock (7,000 underlying)
Conversion
Series D-2 Preferred Stock
2018-06-19−120,000→ 0 total(indirect: By LLC)
→ Common Stock (60,000 underlying)
Conversion
Common Stock
2018-06-19+903,157→ 906,157 total(indirect: By LLC)
Exercise of In-Money
Warrant (right to buy)
2018-06-11−3,000→ 0 total(indirect: By LLC)
Exercise: $16.60→ Common Stock (3,000 underlying)
Exercise/Conversion
Warrant (right to buy)
2018-06-14−10,000→ 0 total
Exercise: $12.20→ Common Stock (10,000 underlying)
Exercise/Conversion
Warrant (right to buy)
2018-06-14−10,000→ 0 total
Exercise: $12.60→ Common Stock (10,000 underlying)

Holdings

Common Stock
(indirect: As UTMA Custodian for daughter)
1,500
Common Stock
(indirect: As UTMA Custodian for daughter)
1,500
Common Stock
(indirect: As UTMA Custodian for son)
1,500

Footnotes (6)

[F1]The shares issuable upon exercise of the warrant are subject to the terms of a lock-up agreement entered into in connection with the Issuer's initial public offering.
[F2]Benjamin Goux is the Chief Financial Officer of and has an economic membership interest in Pioneer Venture Partners, LLC ("Pioneer"), but is not a managing member of Pioneer and does not have voting or dispositive power of the shares held by Pioneer. Mr. Goux disclaims beneficial ownership of these shares except to the extent of his pecuniary interest in the shares, if any.
[F3]Shares of preferred stock automatically converted into shares of common stock on a 2-to-1 basis immediately prior to the closing of the Issuer's initial public offering with cash paid in lieu of a fractional share. The preferred stock had no expiration date.
[F4]The warrant was fully exercisable upon grant.
[F5]Unless sooner exercised, the warrant expires immediately prior to the closing of the Issuer's initial public offering and will be automatically net exercised pursuant to its terms if not exercised prior to that time.
[F6]Transfer of warrant by Mr. Goux to Pioneer; no consideration was paid in connection with the transfer.

Documents

1 file

4
doc4.xmlPrimary
FORM 4 SUBMISSION

Issuer

AVALARA INC

CIK 0001348036

→

Entity typeother

Related Parties

filerCIK 0001741537

Filing Metadata

Form type: 4
Filed: Jun 18, 8:00 PM ET
Accepted: Jun 19, 6:37 PM ET
Size: 78.5 KB

View on SEC.gov