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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^*

Biddle Albert G.W. III

(Last)

(First)

(Middle)

11955 DEMOCRACY DRIVE

SUITE 1700

(Street)

RESTON

20190

(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)

X	Director	X	10% Owner
	Officer (give title below)		Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
12/12/2018

4. 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 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)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Class A Common Stock	12/12/2018		C⁽¹⁾		17,203	A	⁽²⁾⁽³⁾	17,203	I	See Footnote⁽⁴⁾
Class A Common Stock	12/12/2018		J⁽⁵⁾		17,203	D	$0	0	I	See Footnote⁽⁴⁾
Class A Common Stock	12/12/2018		C⁽¹⁾		1,091,751	A	⁽²⁾⁽³⁾	1,091,751	I	See Footnote⁽⁶⁾
Class A Common Stock	12/12/2018		J⁽⁷⁾		1,091,751	D	$0	0	I	See Footnote⁽⁶⁾
Class A Common Stock	12/12/2018		J⁽⁷⁾		972	A	$0	6,139	I	See Footnote⁽⁸⁾
Class A Common Stock								4,925	D

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)
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)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Class B Common Stock	⁽²⁾⁽³⁾	12/12/2018		C⁽¹⁾			17,203	⁽²⁾⁽³⁾	⁽²⁾⁽³⁾	Class A Common Stock	17,203	$0	345,516	I	See Footnote⁽⁴⁾
Class B Common Stock	⁽²⁾⁽³⁾	12/12/2018		J⁽⁵⁾			121,140	⁽²⁾⁽³⁾	⁽²⁾⁽³⁾	Class A Common Stock	121,140	$0	224,376	I	See Footnote⁽⁴⁾
Class B Common Stock	⁽²⁾⁽³⁾	12/12/2018		J⁽⁵⁾		43,367		⁽²⁾⁽³⁾	⁽²⁾⁽³⁾	Class A Common Stock	43,367	$0	300,675	I	See Footnote⁽⁸⁾
Class B Common Stock	⁽²⁾⁽³⁾	12/12/2018		J⁽⁵⁾		5,734		⁽²⁾⁽³⁾	⁽²⁾⁽³⁾	Class A Common Stock	5,734	$0	39,479	I	See Footnote⁽⁹⁾
Class B Common Stock	⁽²⁾⁽³⁾	12/12/2018		J⁽⁵⁾		5,734		⁽²⁾⁽³⁾	⁽²⁾⁽³⁾	Class A Common Stock	5,734	$0	39,479	I	See Footnote⁽¹⁰⁾
Class B Common Stock	⁽²⁾⁽³⁾	12/12/2018		J⁽⁵⁾		5,734		⁽²⁾⁽³⁾	⁽²⁾⁽³⁾	Class A Common Stock	5,734	$0	39,479	I	See Footnote⁽¹¹⁾
Class B Common Stock	⁽²⁾⁽³⁾	12/12/2018		C⁽¹⁾			1,091,751	⁽²⁾⁽³⁾	⁽²⁾⁽³⁾	Class A Common Stock	1,091,751	$0	291,481	I	See Footnote⁽⁶⁾

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 Managing 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 Jack Biddle, Inc. ("JBI"). The Reporting Person is the president of JBI.

9. The reported securities are owned directly by Southgate Partner I ("SPI"), a family trust established for the benefit of the Reporting Person's child. The Reporting Person is the trustee of SPI.

10. The reported securities are owned directly by Southgate Partner II ("SPII"), a family trust established for the benefit of the Reporting Person's child. The Reporting Person is the trustee of SPII.

11. The reported securities are owned directly by Southgate Partners III ("SPIII"), a family trust established for the benefit of the Reporting Person's child. The Reporting Person is the trustee of SPIII.

Remarks:

	/s/ Christopher Winters, Attorney-in-Fact	12/14/2018
	** 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).
** 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.

Exhibit

POWER OF ATTORNEY

Know all by these presents, that the undersigned hereby constitutes and appoints each of Christopher Winters, Angela Patterson, Nicole Brookshire, Mark Ballantyne and Jason Minio, signing individually, the undersigned’s true and lawful attorneys-in fact and agents to:

(1)

execute for and on behalf of the undersigned, in the undersigned’s capacity as an officer, director or beneficial owner of more than 10% of a registered class of securities of Appian Corporation, Forms 3, 4, and 5 (including any amendments thereto) in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”) and the rules thereunder and a Form ID, Uniform Application for Access Codes to File on EDGAR;

(2)

do and perform any and all acts for and on behalf of the undersigned that may be necessary or desirable to execute such Forms 3, 4, or 5, or Form ID (including any amendments thereto) and timely file such forms with the United States Securities and Exchange Commission and any stock exchange or similar authority, including creating a new passphrase and generating new EDGAR access codes via the EDGAR filer manager website; and

(3)

take any other action of any nature whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact’s discretion.

The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact’s substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is Appian Corporation assuming, any of the undersigned’s responsibilities to comply with Section 16 of the Exchange Act.

This Power of Attorney shall remain in full force and effect until the earliest to occur of (a) the undersigned is no longer required to file Forms 3, 4 and 5 with respect to the undersigned’s holdings of and transactions in securities issued by Appian Corporation, (b) revocation by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact or (c) as to any attorney-in-fact individually, until such attorney-in-fact is no longer employed by Appian Corporation or Cooley LLP.

The undersigned has caused this Power of Attorney to be executed as of November 6, 2018.

/s/ A.G.W. “Jack” Biddle, III

A.G.W. “Jack” Biddle, III

Director