| FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
|
|||||||||||||||
| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
| Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10. | |||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
|
2. Issuer Name and Ticker or Trading Symbol
QLIK TECHNOLOGIES INC [ QLIK ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
||||||||||||||||||||||||
|
3. Date of Earliest Transaction
(Month/Day/Year) 03/02/2011 | ||||||||||||||||||||||||||
|
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
|
| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction 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 | 03/02/2011 | J(1) | 11,502,533 | D | $0 | 0 | I | See Footnote(2) | ||
| Common Stock | 03/02/2011 | J(3) | 275,610 | D | $0 | 0 | I | See Footnote(4) | ||
| Common Stock | 03/02/2011 | J(5) | 4,928 | A | $0 | 4,928 | I | See Footnote(6) | ||
| Common Stock | 03/02/2011 | J(7) | 296,529 | A | $0 | 296,529 | I | See Footnote(8) | ||
| Common Stock | 03/02/2011 | J(9) | 88,541 | A | $0 | 88,541 | I | See Footnote(10) | ||
| Common Stock | 03/02/2011 | J(11) | 92,897 | A | $0 | 92,897 | I | See Footnote(12) | ||
| Common Stock | 03/02/2011 | J(13) | 91,407 | A | $0 | 91,407 | I | See Footnote(14) | ||
|
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 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: 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 | ||||||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
| ||||||||||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
| ||||||||||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
| ||||||||||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
| ||||||||||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
| ||||||||||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
|
| Explanation of Responses: |
| 1. Represents a pro rata distribution without additional consideration by Accel Europe L.P. ("AE") to its partners. |
| 2. The reportable securities are owned directly by AE. James R. Swartz and Kevin Comolli (collectively the "AEA Managers") are the managers of Accel Europe Associates L.L.C. ("AEA LLC"). AEA LLC is the general partner of Accel Europe Associates L.P. ("AEA LP"), which is the general partner of AE. The AEA Managers, AEA LLC and AEA LP may be deemed to share voting and dispositive power over the shares held by AE and disclaim beneficial ownership of shares held by AE except to the extent of any pecuniary interest therein. |
| 3. Represents a pro rata distribution without additional consideration by Accel Europe Investors 2004 L.P. ("AEI") to its partners. |
| 4. The reportable securities are owned directly by AEI. The AEA Managers are the managers of AEA LLC. AEA LLC is the general partner of AEI. The AEA Managers and AEA LLC may be deemed to share voting and dispositive power over the shares held by AEI and disclaim beneficial ownership of shares held by AEI except to the extent of any pecuniary interest therein. |
| 5. Acquisition by Kevin Comolli pursuant to a pro rata distribution without additional consideration by AE and AEI. |
| 6. The reportable securities are owned directly by Kevin Comolli. |
| 7. Acquisition by Rothschild Trust (Bermuda) Limited ("RTBL"), as trustee of the Max Trust, pursuant to a pro rata distribution without additional consideration by AE and AEI. |
| 8. The reportable securities are owned directly by RTBL, as trustee of the Max Trust. Kevin Comolli is a beneficiary of the Max Trust. |
| 9. Acquisition by James R. Swartz pursuant to a pro rata distribution without additional consideration by AE and AEI. |
| 10. The reportable securities are owned directly by James R. Swartz. |
| 11. Acquisition by Burn3 LLC pursuant to a pro rata distribution without additional consideration by AE and AEI. |
| 12. The reportable securities are owned directly by Burn3 LLC. James R. Swartz is the manager of Burn3 LLC. |
| 13. Acquisition by Homestake Partners L.P. ("Homestake") pursuant to a pro rata distribution without additional consideration by AE and AEI. |
| 14. The reportable securities are owned directly by Homestake Partners L.P. ("Homestake"). James R. Swartz is a general partner of Homestake. |
| /s/ Jonathan Biggs, Attorney-in-Fact for James R. Swartz | 03/04/2011 | |
| /s/ Jonathan Biggs, Attorney-in-Fact for Kevin Comolli | 03/04/2011 | |
| /s/ Jonathan Biggs, Attorney-in-Fact for Accel Europe L.P. | 03/04/2011 | |
| /s/ Jonathan Biggs, Attorney-in-Fact for Accel Europe Investors 2004 L.P. | 03/04/2011 | |
| /s/ Jonathan Biggs, Attorney-in-Fact for Accel Europe Associates L.L.C. | 03/04/2011 | |
| /s/ Jonathan Biggs, Attorney-in-Fact for Accel Europe Associates L.P. | 03/04/2011 | |
| ** 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 Number. | ||