Statement of Changes in Beneficial Ownership (4)
04 Januar 2022 - 11:40PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
|
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OMB Number: 3235-0287
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Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
|
|
| 1. Name
and Address of Reporting Person * McFarlane Scott M |
2. Issuer Name and Ticker or Trading
Symbol AVALARA, INC. [ AVLR ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
See Remarks |
|
(Last)
(First)
(Middle)
255 SOUTH KING ST., SUITE 1800 |
3. Date of Earliest Transaction (MM/DD/YYYY)
1/3/2022
|
|
(Street)
SEATTLE, WA 98104
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
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. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. 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 |
|
Common Stock |
1/3/2022 |
|
S(1) |
|
2986 |
D |
$129.00 |
576484 |
D |
|
|
Common Stock |
|
|
|
|
|
|
|
109375 |
I |
By McFarlane Family Investments,
LLC (2) |
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. 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 |
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 of Derivative Security: 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 |
| Explanation of
Responses: |
| (1) |
This prearranged sale was
effected pursuant to a written authorization executed by the
Reporting Person on September 10, 2019, and represents shares
required to be sold to cover tax withholding obligations in
connection with the vesting of restricted stock units. |
| (2) |
The Reporting Person
disclaims beneficial ownership of the shares of Common Stock held
by McFarlane Family Investments, LLC, of which the Reporting Person
is the sole manager and a member, except to the extent of his
pecuniary interest therein, if any. |
Remarks:
Chairman and Chief Executive Officer |
Reporting
Owners
|
|
Reporting Owner Name / Address |
Relationships
|
|
Director |
10% Owner |
Officer |
Other |
McFarlane Scott M
255 SOUTH KING ST.
SUITE 1800
SEATTLE, WA 98104 |
X |
|
See Remarks |
|
Signatures
|
|
/s/ Miles Treakle,
Attorney-in-Fact |
|
1/4/2022 |
| **Signature of Reporting
Person |
Date |
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