SEC FORM 3/A 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*
Neeleman Stephen

(Last) (First) (Middle)
C/O HEALTHEQUITY, INC.
15 W. SCENIC POINTE DR., STE. 100

(Street)
DRAPER UT 84020

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/30/2014
3. Issuer Name and Ticker or Trading Symbol
HEALTHEQUITY INC [ HQY ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Founder and Vice Chairman
5. If Amendment, Date of Original Filed (Month/Day/Year)
07/30/2014
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 715,002(1) D
Common Stock 15,137(1) I By wife
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
Series B Preferred Stock (2) (2) Common Stock 53,334(1) (2) I By wife
Explanation of Responses:
1. The reporting person's original Form 3 identified 730,139 shares of common stock and 53,334 shares of Series B Preferred Stock as directly held by the reporting person when 15,137 of such reported shares of common stock and all of such reported shares of Series B Preferred Stock are held by his wife.
2. The reported securities automatically converted into shares of common stock on August 4, 2014.
Remarks:
/s/ Stephen D. Neeleman, M.D. 08/06/2014
** 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.
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