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*
Collins Patrick J III

(Last) (First) (Middle)
C/O ARLO TECHNOLOGIES, INC.
350 EAST PLUMERIA DRIVE

(Street)
SAN JOSE CA 95134

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/07/2018
3. Issuer Name and Ticker or Trading Symbol
Arlo Technologies, Inc. [ ARLO ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
See Remarks
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)
Common Stock, par value $0.001 per share 0 D
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
Stock Option (1) 08/02/2028 Common Stock, par value $0.001 per share 437,500 $16 D
Explanation of Responses:
1. In general: (a) 25% of the options will vest in equal monthly installments during the 24-month period that begins on August 2, 2020, (b) 25% of the options will vest over a four-year period based on satisfaction of a cumulative registered users milestone, (c) 25% of the options will vest over a four year period based on satisfaction of a paid recurring revenue milestone, (d) 12.5% of the options will vest at the end of 2018 based on the extent to which revenue and gross profit milestones for the second half of fiscal 2018 are achieved, and (e) 12.5% of the options will vest at the end of 2019 based on the extent to which revenue and gross profit milestones for fiscal 2019 are achieved, subject, in each case, to applicable service requirements. The options also include accelerated vesting provisions in the case of certain terminations of employment.
Remarks:
Senior Vice President of Product
/s/ PATRICK J. COLLINS III 08/07/2018
** 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.