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 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Accolade, Inc. [ ACCD ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 07/07/2020 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 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 | 07/07/2020 | C | 3,354,507 | A | (1) | 3,389,507 | I | By AH Parallel Fund IV, L.P.(2)(3) | ||
Common Stock | 07/07/2020 | X | 354,658 | A | $0.0005 | 3,744,165 | I | By AH Parallel Fund IV, L.P.(2)(3) | ||
Common Stock | 07/07/2020 | S(4) | 9 | D | $22 | 3,744,156 | I | By AH Parallel Fund IV, L.P.(2)(3) | ||
Common Stock | 07/07/2020 | X | 35,465 | A | $0.0005 | 3,779,621 | I | By AH Parallel Fund IV, L.P.(2)(3) | ||
Common Stock | 07/07/2020 | S(5) | 1 | D | $22 | 3,779,620 | I | By AH Parallel Fund IV, L.P.(2)(3) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 | ||||||||
Series E Preferred Stock | (1) | 07/07/2020 | C | 1,609,159 | (1) | (1) | Common Stock | 3,354,507 | $0.00 | 0 | I | By AH Parallel Fund IV, L.P.(2)(3) | |||
Warrant (Right to Buy) | $0.0005 | 07/07/2020 | X | 354,658 | (6) | 07/26/2026 | Common Stock | 354,658 | $0.00 | 0 | I | By AH Parallel Fund IV, L.P.(2)(3) | |||
Warrant (Right to Buy) | $0.0005 | 07/07/2020 | X | 35,465 | (6) | 03/16/2028 | Common Stock | 35,465 | $0.00 | 0 | I | By AH Parallel Fund IV, L.P.(2)(3) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. The Series E Preferred Stock automatically converted into shares of Common Stock of the Issuer on a 1:2.084634091 basis immediately upon closing of the Issuer's initial public offering and had no expiration date. |
2. These securities are held of record by AH Parallel Fund IV, L.P., for itself and as nominee for AH Parallel Fund IV-A, L.P., AH Parallel Fund IV- B, L.P., and AH Parallel Fund IV-Q, L.P. (collectively the "AH Parallel Fund IV Entities"). AH Equity Partners IV (Parallel), L.L.C. ("AH EP IV Parallel") is the general partner of the AH Parallel Fund IV Entities and has sole voting and dispositive power with regard to the securities held by the AH Parallel Fund IV Entities. The managing members of AH EP IV Parallel are Marc Andreessen and Benjamin Horowitz. Marc Andreessen and Benjamin Horowitz share voting and dispositive power with respect to the securities held by the AH Parallel Fund IV Entities. |
3. (Continued from Footnote 3) Such persons and entities disclaim the existence of a "group" and disclaim beneficial ownership of the securities held by the AH Parallel Fund IV Entities and this report shall not be deemed an admission that any such person is the beneficial owner of such securities, except to the extent of his or its pecuniary interest, if any, in such securities by virtue of his or its interest in the AH Parallel Fund IV Entities and/or AH EP IV Parallel, as applicable. |
4. Upon closing of the Issuer's initial public offering, AH Parallel Fund IV, L.P. exercised a warrant to purchase 354,658 shares of the Issuer's Common Stock at an exercise price per share of $0.0005. AH Parallel Fund IV, L.P. paid the exercise price on a cashless basis, resulting in the Issuer withholding 9 shares subject to the warrant in order to pay the exercise price and issuing to AH Parallel Fund IV, L.P. the remaining 354,649 shares of Common Stock. |
5. Upon closing of the Issuer's initial public offering, AH Parallel Fund IV, L.P. exercised a warrant to purchase 35,465 shares of the Issuer's Common Stock at an exercise price per share of $0.0005. AH Parallel Fund IV, L.P. paid the exercise price on a cashless basis, resulting in the Issuer withholding 1 share subject to the warrant in order to pay the exercise price and issuing to AH Parallel Fund IV, L.P. the remaining 35,464 shares of Common Stock. |
6. The shares subject to this warrant are fully vested. |
Remarks: |
This Form 4 is the first of two Form 4s filed relating to the same event. Combined, the two reports report the holdings for the following reporting persons: AH Parallel Fund IV, L.P., AH Parallel Fund IV-A, L.P., AH Parallel Fund IV-B, L.P., AH Parallel Fund IV-Q, L.P., AH Equity Partners IV (Parallel), L.L.C., Andreessen Horowitz Fund IV, L.P., Andreessen Horowitz Fund IV-A, L.P., Andreessen Horowitz Fund IV-B, L.P., Andreessen Horowitz Fund IV-Q, L.P., AH Equity Partners IV, L.L.C., Marc Andreessen and Benjamin Horowitz. This Form 3 has been split into two filings because there are more than 10 reporting persons in total, and the SEC's EDGAR filing system limits a single Form 4 to a maximum of 10 reporting persons. |
AH Parallel Fund IV, L.P., By: AH Equity Partners IV (Parallel), L.L.C. Its: General Partner, By: /s/ Scott Kupor, Chief Operating Officer | 07/08/2020 | |
AH Parallel Fund IV-A, L.P. By: AH Equity Partners IV (Parallel), L.L.C. Its: General Partner By: /s/ Scott Kupor Scott Kupor, Chief Operating Officer | 07/08/2020 | |
AH Parallel Fund IV-B, L.P. By: AH Equity Partners IV (Parallel), L.L.C. Its: General Partner By: /s/ Scott Kupor Scott Kupor, Chief Operating Officer | 07/08/2020 | |
AH Parallel Fund IV-Q, L.P. By: AH Equity Partners IV (Parallel), L.L.C. Its: General Partner By: /s/ Scott Kupor Scott Kupor, Chief Operating Officer | 07/08/2020 | |
AH Equity Partners IV (Parallel), L.L.C. By: /s/ Scott Kupor Scott Kupor, Chief Operating Officer | 07/08/2020 | |
AH Equity Partners IV, L.L.C. By: /s/ Scott Kupor Scott Kupor, Chief Operating Officer | 07/08/2020 | |
** 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. |