SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
Evans David Thomas

(Last) (First) (Middle)
C\O CARDLYTICS, INC.
675 PONCE DE LEON AVENUE NE, SUITE 6000

(Street)
ATLANTA GA 30308

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/08/2018
3. Issuer Name and Ticker or Trading Symbol
Cardlytics, Inc. [ CDLX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
5. 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 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)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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: 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
Restricted Stock Unit (1) (1) Series G? Redeemable Convertible Preferred Stock 621 (2) D
Restricted Stock Unit (1) (1) Series G? Redeemable Convertible Preferred Stock 2,045 (2) D
Restricted Stock Unit (1) (1) Series G? Redeemable Convertible Preferred Stock 1,193 (2) D
Employee Stock Option (Right to Buy) (3) 08/08/2024 Common Stock 32,500 $9.08 D
Employee Stock Option (Right to Buy) (4) 08/02/2026 Common Stock 60,007 $20 D
Employee Stock Option (Right to Buy) (5) 08/02/2026 Common Stock 37,499 $20 D
Employee Stock Option (Right to Buy) (6) 12/06/2026 Common Stock 37,500 $20 D
Employee Stock Option (Right to Buy) (7) 07/07/2027 Common Stock 37,500 $30.44 D
Explanation of Responses:
1. The restricted stock units (the "RSUs") will vest and settle upon the completion of the Issuer's initial public offering.
2. Each RSU represents a contingent right to receive one share of the Issuer's Series G' Redeemable Convertible Preferred Stock.
3. This option became exercisable with respect to one quarter (1/4) of the shares of stock subject to this option on August 8, 2015 (the "Initial Vesting Date"). The option becomes exercisable in respect of the remaining shares in thirty-six (36) equal monthly installments commencing one (1) month after the Initial Vesting Date, provided the Reporting Person continuously provides service to the Issuer through each vesting period.
4. This option became exercisable with respect to one quarter (1/4) of the shares of stock subject to this option on June 15, 2017 (the "Initial Vesting Date"). The option becomes exercisable in respect of the remaining shares in thirty-six (36) equal monthly installments commencing one (1) month after the Initial Vesting Date, provided the Reporting Person continuously provides service to the Issuer through each vesting period.
5. Fully vested.
6. This option became exercisable with respect to one quarter (1/4) of the shares of stock subject to this option on December 6, 2017 (the "Initial Vesting Date"). The options becomes exercisable in respect of the remaining shares in thirty-six (36) equal monthly installments commencing one (1) month after the Initial Vesting Date, provided the Reporting Person continuously provides service to the Issuer through each vesting period.
7. This option becomes exercisable with respect to one quarter (1/4) of the shares of stock subject to this option on April 1, 2018 (the "Initial Vesting Date"). The option becomes exercisable in respect of the remaining shares in thirty-six (36) equal monthly installments commencing one (1) month after the Initial Vesting Date, provided the Reporting Person continuously provides service to the Issuer through each vesting period.
Remarks:
Exhibit List - Exhibit 24 - Power of Attorney
/s/ Kirk L. Somers, Attorney-in-Fact 02/08/2018
** 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 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).
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.