Sec Form 3 Filing - JORDAN JEFFREY D @ Accolade, Inc. - 2020-07-01

Insider filing report for Changes in Beneficial Ownership
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FORM 3
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
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
JORDAN JEFFREY D
2. Issuer Name and Ticker or Trading Symbol
Accolade, Inc. [ ACCD]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O ACCOLADE, INC., 1201 THIRD AVENUE, SUITE 1700
3. Date of Earliest Transaction (MM/DD/YY)
07/01/2020
(Street)
SEATTLE, WA98101
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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
Common Stock 35,000 I By AH Parallel Fund IV, L.P. ( 1 ) ( 2 )
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 (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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
Series E Preferred Stock ( 3 ) ( 3 ) ( 3 ) Common Stock ( 3 ) I By AH Parallel Fund IV, L.P. ( 1 ) ( 2 )
Series E Preferred Stock ( 4 ) ( 4 ) ( 4 ) Common Stock ( 4 ) I By Andreessen Horowitz Fund IV, L.P. ( 2 ) ( 5 )
Warrant (Right to Buy) $ 0.0005 ( 6 ) 07/26/2026( 7 ) Common Stock 354,658 I By AH Parallel Fund IV, L.P. ( 1 ) ( 2 )
Warrant (Right to Buy) $ 0.0005 ( 6 ) 03/16/2028( 7 ) Common Stock 35,465 I By AH Parallel Fund IV, L.P. ( 1 ) ( 2 )
Warrant (Right to Buy) $ 0.0005 ( 6 ) 07/26/2026( 7 ) Common Stock 153,346 I By Andreessen Horowitz Fund IV, L.P. ( 2 ) ( 5 )
Warrant (Right to Buy) $ 0.0005 ( 6 ) 03/16/2028( 7 ) Common Stock 15,334 I By Andreessen Horowitz Fund IV, L.P. ( 2 ) ( 5 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
JORDAN JEFFREY D
C/O ACCOLADE, INC.
1201 THIRD AVENUE, SUITE 1700
SEATTLE, WA98101
X
Signatures
/s/ Alan Hambelton, Attorney-in-Fact 07/01/2020
Signature of Reporting Person Date
Explanation of Responses:
( 1 )These shares are held of record by AH Parallel Fund IV, L.P., for itself and as nominee for AH Parallel Fund IV-A, L.P., AH Parallel Fund IV-B, L.P. and AH Parallel Fund IV-Q, L.P. (the "AH Parallel Fund IV Entities"). AH Equity Partners IV (Parallel), L.L.C. ("AH EP IV Parallel") is the general partner of the AH Parallel Fund IV Entities and has sole voting and dispositive power with regard to the shares held by the AH Parallel Fund IV Entities. The managing members of AH EP IV Parallel are Marc Andreessen and Benjamin Horowitz. Marc Andreessen and Benjamin Horowitz share voting and dispositive power with respect to the shares held by the AH Parallel Fund IV Entities.
( 2 )Mr. Jordan is a member of the general partners of the Andreessen Horowitz Entities (as defined herein), but he disclaims the existence of a "group" and disclaims beneficial ownership of the shares held by the Andreessen Horowitz Entities and this report shall not be deemed an admission that he is the beneficial owner of such shares, except to the extent of his pecuniary interest, if any, in such shares by virtue of his interest in the Andreessen Horowitz Entities, and/or the general partner entities thereof, as applicable.
( 3 )AH Parallel Fund IV, L.P. currently holds 1,609,159 shares of the Issuer's Series E Preferred Stock. Each share of the Issuer's Series E Preferred Stock has no expiration date and will automatically convert, on a certificate by certificate basis, upon the closing of the Issuer's initial public offering (the "IPO") into the number shares of the Issuer's Common Stock equal to (i) 1,609,159 plus (ii) a number equal to 1,609,159 multiplied by a fraction of $23.86195 divided by the Issuer's initial public offering price per share of the Issuer's Common Stock offered to the public in the IPO. No fractional shares shall be issued as a result of this conversion.
( 4 )Andreessen Horowitz Fund IV, L.P. currently holds 695,764 shares of the Issuer's Series E Preferred Stock. Each share of the Issuer's Series E Preferred Stock has no expiration date and will automatically convert, on a certificate by certificate basis, upon the closing of the IPO into the number shares of the Issuer's Common Stock equal to (i) 695,764 plus (ii) a number equal to 695,764 multiplied by a fraction of $23.86195 divided by the Issuer's initial public offering price per share of the Issuer's Common Stock offered to the public in the IPO. No fractional shares shall be issued as a result of this conversion.
( 5 )These shares are held of record by Andreessen Horowitz Fund IV, L.P., for itself and as nominee for Andreessen Horowitz Fund IV-A, L.P., Andreessen Horowitz Fund IV-B, L.P. and Andreessen Horowitz Fund IV-Q, L.P. (the "AH Fund IV Entities" and together with the AH IV Parallel Entities, the "Andreessen Horowitz Entities"). AH Equity Partners IV, L.L.C. ("AH EP IV") is the general partner of the AH Fund IV Entities and has sole voting and dispositive power with regard to the shares held by the AH Fund IV Entities. The managing members of AH EP IV are Marc Andreessen and Benjamin Horowitz. Marc Andreessen and Benjamin Horowitz share voting and dispositive power with respect to the shares held by the AH Fund IV Entities.
( 6 )The shares subject to this warrant are fully vested.
( 7 )This warrant will automatically be net exercised upon closing of the IPO if it is not exercised on or before such date.

Remarks:
Exhibit 24 - Power of Attorney

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