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QUALYS, INC. — Director's Dealing 2012
Sep 27, 2012
31029_dirs_2012-09-27_d06a060f-5bcb-407b-88a2-680a49e5eb10.zip
Director's Dealing
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SEC Form 3 — Initial Statement of Beneficial Ownership
Issuer: QUALYS, INC. (QLYS)
CIK: 0001107843
Period of Report: 2012-09-27
Reporting Person: DIXON DONALD R (Director, 10% Owner)
Holdings (Non-Derivative)
| Security | Shares | Ownership |
|---|---|---|
| Common Stock | 278981 | Indirect |
| Common Stock | 21192 | Indirect |
| Common Stock | 8073 | Indirect |
| Common Stock | 1620 | Indirect |
| Common Stock | 1545 | Indirect |
Holdings (Derivative)
| Security | Exercise Price | Expiration | Underlying | Shares | Ownership |
|---|---|---|---|---|---|
| Series A Preferred Stock | $ | Common Stock (1346877) | Indirect | ||
| Series A Preferred Stock | $ | Common Stock (102325) | Indirect | ||
| Series A Preferred Stock | $ | Common Stock (32622) | Indirect | ||
| Series A Preferred Stock | $ | Common Stock (7826) | Indirect | ||
| Series A Preferred Stock | $ | Common Stock (7468) | Indirect | ||
| Series B Preferred Stock | $ | Common Stock (3743844) | Indirect | ||
| Series B Preferred Stock | $ | Common Stock (284432) | Indirect | ||
| Series B Preferred Stock | $ | Common Stock (108359) | Indirect | ||
| Series B Preferred Stock | $ | Common Stock (21758) | Indirect | ||
| Series B Preferred Stock | $ | Common Stock (20762) | Indirect | ||
| Series C Preferred Stock | $ | Common Stock (269599) | Indirect | ||
| Series C Preferred Stock | $ | Common Stock (20481) | Indirect | ||
| Series C Preferred Stock | $ | Common Stock (7802) | Indirect | ||
| Series C Preferred Stock | $ | Common Stock (1566) | Indirect | ||
| Series C Preferred Stock | $ | Common Stock (1494) | Indirect |
Footnotes
F1: The Reporting Person serves as a Managing Director of Trident Capital Management-V, L.L.C. ("TCMV"). TCMV is the general partner of each of Trident Capital Fund-V, L.P., Trident Capital Fund-V Affiliates Fund, L.P., Trident Capital Fund-V Affiliates Fund (Q), L.P. and Trident Capital Fund-V Principals Fund, L.P. and the sole investment general partner of Trident Capital Parallel Fund-V, C.V. As such, the Reporting Person may be deemed to share voting and dispositive power with respect to the shares held by each of these Trident entities. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purpose.
F2: The reported securities are held directly by Trident Capital Fund-V, L.P.
F3: The reported securities are held directly by Trident Capital Parallel Fund-V, C.V.
F4: The reported securities are held directly by Trident Capital Fund-V Principals Fund, L.P.
F5: The reported securities are held directly by Trident Capital Fund-V Affiliates Fund, L.P.
F6: The reported securities are held directly by Trident Capital Fund-V Affiliates Fund (Q), L.P.
F7: Each share of Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock shall automatically convert into Common Stock on a 1-for-1 basis upon the completion of the Issuer's initial public offering of Common Stock and has no expiration date.