SEC FORM 4 SEC Form 4
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*
Novak Biddle Co V, LLC

(Last) (First) (Middle)
7501 WISCONSIN AVENUE, EAST TOWER
SUITE 1380

(Street)
BETHESDA MD 20814

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
APPIAN CORP [ APPN ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
07/01/2018
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
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
Class A Common Stock 07/01/2018 C(1) 360,360 A (2)(3) 360,360 I See Footnote(4)
Class A Common Stock 07/01/2018 J(5) 360,360 D $0 0 I See Footnote(4)
Class A Common Stock 07/01/2018 C(1) 2,371,242 A (2)(3) 2,371,242 I See Footnote(6)
Class A Common Stock 07/01/2018 J(7) 2,371,242 D $0 0 I See Footnote(6)
Class A Common Stock 1,047 I See Footnote(8)
Class A Common Stock 349 I See Footnote(9)
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
Class B Common Stock (2)(3) 07/01/2018 C(1) 360,360 (2)(3) (2)(3) Class A Common Stock 360,360 $0 964,546 I See Footnote(4)
Class B Common Stock (2)(3) 07/01/2018 J(5) 263,640 (2)(3) (2)(3) Class A Common Stock 263,640 $0 700,906 I See Footnote(4)
Class B Common Stock (2)(3) 07/01/2018 J(5) 98,867 (2)(3) (2)(3) Class A Common Stock 98,867 $0 156,273 I See Footnote(8)
Class B Common Stock (2)(3) 07/01/2018 J(5) 32,953 (2)(3) (2)(3) Class A Common Stock 32,953 $0 52,087 I See Footnote(9)
Class B Common Stock (2)(3) 07/01/2018 C(1) 2,371,242 (2)(3) (2)(3) Class A Common Stock 2,371,242 $0 4,052,066 I See Footnote(6)
Class B Common Stock (2)(3) 07/01/2018 J(7) 4,758 (2)(3) (2)(3) Class A Common Stock 4,758 $0 4,047,308 I See Footnote(6)
Class B Common Stock (2)(3) 07/01/2018 J(7) 793 (2)(3) (2)(3) Class A Common Stock 793 $0 157,066 I See Footnote(8)
Class B Common Stock (2)(3) 07/01/2018 J(7) 264 (2)(3) (2)(3) Class A Common Stock 264 $0 52,351 I See Footnote(9)
1. Name and Address of Reporting Person*
Novak Biddle Co V, LLC

(Last) (First) (Middle)
7501 WISCONSIN AVENUE, EAST TOWER
SUITE 1380

(Street)
BETHESDA MD 20814

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Novak Biddle Venture Partners V L P

(Last) (First) (Middle)
7501 WISCONSIN AVENUE, EAST TOWER
SUITE 1380

(Street)
BETHESDA MD 20815

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Novak E Rogers JR

(Last) (First) (Middle)
7501 WISCONSIN AVENUE, EAST TOWER
SUITE 1380

(Street)
BETHESDA MD 20814

(City) (State) (Zip)
Explanation of Responses:
1. Pursuant to the terms of the Class B Common Stock, the Reporting Person converted shares of Class B Common Stock into shares of Class A Common Stock.
2. Each share of Class B Common Stock is convertible at any time at the option of the holder into one share of Class A Common Stock and has no expiration date. In addition, each share of Class B Common Stock will convert automatically into one share of Class A Common Stock upon (1) any transfer, whether or not for value and whether voluntary or involuntary or by operation of law, except for certain transfers described in the Issuer's certificate of incorporation, including, without limitation, certain transfers for tax and estate planning purposes or (continued to Footnote (3))
3. (continued from Footnote (2)) (2) the death or disability, as defined in the Issuer's certificate of incorporation, of the applicable Class B common stockholder (or nine months after the date of death or disability if the stockholder is one of the Issuer's founders). In addition, on the first trading day following the date on which the outstanding shares of Class B Common Stock represent less than 10% of the aggregate voting power of the Issuer's then outstanding capital stock, all outstanding shares of Class B Common Stock shall convert automatically into Class A Common Stock, and no additional shares of Class B Common Stock will be issued.
4. The reported securities are owned directly by Novak Biddle Company V, LLC ("NBCV"). A.G.W. Biddle III and E. Rogers Novak, Jr. (collectively, the "Managing Members") are the managing members of NBCV. The Managing Members disclaim beneficial ownership of all the shares owned by NBCV and this report shall not be deemed an admission that they are the beneficial owner of such shares for purposes of Section 16 or for any other purpose, except to the extent of their pecuniary interests therein.
5. Represents a pro rata distribution without additional consideration by NBCV to its partners.
6. The reported securities are owned directly by Novak Biddle Venture Partners V, L.P. ("NBVPV"). NBCV is the general partner of NBVPV and the " Members are the managing members of NBCV. Each of NBCV and the Managing Members disclaim beneficial ownership of all the shares owned by NBVPV and this report shall not be deemed an admission that either is the beneficial owner of such shares for purposes of Section 16 or for any other purpose, except to the extent of their pecuniary interests therein.
7. Represents a pro rata distribution without additional consideration by NBVPV to its limited partners.
8. The reported securities are owned directly by Novak Holdings, LLC ("NH"). Mr. Novak is the sole general member of NH.
9. The reported securities are owned directly by Wells Fargo Bank NA FBO E.R. Novak Jr MGD IRA. Mr. Novak has sole voting and dispositive power of these shares.
Remarks:
/s/ Lauren Ackermann, Attorney-in-Fact for Novak Biddle Co V, LLC 07/03/2018
** 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).
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