SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
Hansen Megan

(Last) (First) (Middle)
C/O SMARTSHEET INC.
10500 NE 8TH ST., SUITE 1300

(Street)
BELLEVUE WA 98004-4357

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/19/2021
3. Issuer Name and Ticker or Trading Symbol
SMARTSHEET INC [ SMAR ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief People & Culture Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Class A Common Stock 5,944 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Restricted Stock Units (RSU) (Class A) (1) 08/27/2029 Class A Common Stock 9,233 (2) D
Restricted Stock Units (RSU) (Class A) (3) 03/16/2030 Class A Common Stock 6,864 (2) D
Explanation of Responses:
1. The RSUs vested as to 25% of the total shares on July 15, 2020 and then 6.25% of the total shares vest quarterly thereafter, with 100% of the total shares vested and exercisable on July 15, 2023, subject to the reporting person's provision of service to the issuer on each vesting date.
2. Each RSU represents a contingent right to receive 1 share of the issuer's Class A Common Stock upon settlement.
3. The RSUs vested as to 25% of the total shares on February 15, 2021 and then 6.25% of the total shares vest quarterly thereafter, with 100% of the total shares vested on February 15, 2024, subject to the reporting person's provision of service to the issuer on each vesting date.
Remarks:
Exhibit List - Exhibit 24 - Power of Attorney
/s/ Paul Porrini as attorney-in-fact for Megan Hansen 03/23/2021
** 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 5 (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.