1. Name and Address of Reporting Person * |
Â
Marcus Adam D. |
|
2. Date of Event Requiring Statement (Month/Day/Year) 11/12/2015 |
3. Issuer Name and Ticker or Trading Symbol INSTRUCTURE INC [INST]
|
C/O INSTRUCTURE, INC., 6330 SOUTH 3000 EAST, SUITE 700 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
__X__ Director |
__X__ 10% Owner |
_____ Officer (give title below) |
_____ Other (specify below) |
|
|
5. If Amendment, Date Original Filed(Month/Day/Year)
|
SALT LAKE CITY, UT 84121 |
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) |
Common Stock
|
4,216
|
I
|
By OpenView Affiliates Fund II, L.P.
(1)
|
Common Stock
|
6,353
|
I
|
By OpenView Affiliates Fund, L.P.
(1)
|
Common Stock
|
85,561
|
I
|
By OpenView Venture Partners II, L.P.
(1)
|
Common Stock
|
83,424
|
I
|
By OpenView Venture Partners, L.P.
(1)
|
|
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 of Derivative Security: 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 |
Series A Preferred Stock
|
Â
(2)
|
Â
(3)
|
Common Stock
|
3,126
|
$
(2)
|
I
|
By OpenView Affiliates Fund II, L.P.
(1)
|
Series A Preferred Stock
|
Â
(2)
|
Â
(3)
|
Common Stock
|
4,710
|
$
(2)
|
I
|
By OpenView Affiliates Fund, L.P.
(1)
|
Series A Preferred Stock
|
Â
(2)
|
Â
(3)
|
Common Stock
|
63,433
|
$
(2)
|
I
|
By OpenView Venture Partners II, L.P.
(1)
|
Series A Preferred Stock
|
Â
(2)
|
Â
(3)
|
Common Stock
|
61,849
|
$
(2)
|
I
|
By OpenView Venture Partners, L.P.
(1)
|
Series B Preferred Stock
|
Â
(4)
|
Â
(3)
|
Common Stock
|
92,090
|
$
(4)
|
I
|
By OpenView Affiliates Fund II, L.P.
(1)
|
Series B Preferred Stock
|
Â
(4)
|
Â
(3)
|
Common Stock
|
138,752
|
$
(4)
|
I
|
By OpenView Affiliates Fund, L.P.
(1)
|
Series B Preferred Stock
|
Â
(4)
|
Â
(3)
|
Common Stock
|
1,868,694
|
$
(4)
|
I
|
By OpenView Venture Partners II, L.P.
(1)
|
Series B Preferred Stock
|
Â
(4)
|
Â
(3)
|
Common Stock
|
1,822,031
|
$
(4)
|
I
|
By OpenView Venture Partners, L.P.
(1)
|
Series C Preferred Stock
|
Â
(5)
|
Â
(3)
|
Common Stock
|
16,880
|
$
(5)
|
I
|
By OpenView Affiliates Fund II, L.P.
(1)
|
Series C Preferred Stock
|
Â
(5)
|
Â
(3)
|
Common Stock
|
25,436
|
$
(5)
|
I
|
By OpenView Affiliates Fund, L.P.
(1)
|
Series C Preferred Stock
|
Â
(5)
|
Â
(3)
|
Common Stock
|
342,563
|
$
(5)
|
I
|
By OpenView Venture Partners II, L.P.
(1)
|
Series C Preferred Stock
|
Â
(5)
|
Â
(3)
|
Common Stock
|
334,008
|
$
(5)
|
I
|
By OpenView Venture Partners, L.P.
(1)
|
* |
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). |
(1) |
OpenView Management, LLC is the general partner of the general partner of each of OpenView Affiliates Fund II, L.P., OpenView Affiliates Fund, L.P., OpenView Venture Partners II, L.P. and OpenView Venture Partners, L.P. Mr. Marcus is a managing partner at OpenView Venture Partners. Mr. Marcus disclaims beneficial ownership of the securities held by these entities, except to the extent of his pecuniary interest therein. |
(2) |
The Series A Preferred Stock is convertible into Common Stock of the Issuer at the option of the holder. The Series A Preferred Stock will automatically convert into Common Stock of the Issuer on a 1-to-1 basis upon closing of the initial public offering of the Issuer. |
(3) |
Not applicable. |
(4) |
The Series B Preferred Stock is convertible into Common Stock of the Issuer at the option of the holder. The Series B Preferred Stock will automatically convert into Common Stock of the Issuer on a 1-to-1 basis upon closing of the initial public offering of the Issuer. |
(5) |
The Series C Preferred Stock is convertible into Common Stock of the Issuer at the option of the holder. The Series C Preferred Stock will automatically convert into Common Stock of the Issuer on a 1-to-1 basis upon closing of the initial public offering of the Issuer. |