SEC FORM
3
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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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
C/O OOMA, INC. |
525 ALMANOR AVE., SUITE 200 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 06/01/2022
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3. Issuer Name and Ticker or Trading Symbol
OOMA INC
[ OOMA ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
X |
Officer (give title below) |
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Other (specify below) |
Chief Accounting Officer |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Common Stock |
33,315
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D |
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Employee Stock Option (Right to Buy) |
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03/30/2025 |
Common Stock |
5,000 |
9.18 |
D |
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Employee Stock Option (Right to Buy) |
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03/15/2030 |
Common Stock |
1,500 |
10.52 |
D |
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Employee Stock Option (Right to Buy) |
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03/01/2031 |
Common Stock |
1,000 |
16.28 |
D |
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Explanation of Responses: |
Remarks: |
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/s/ Namrata Sabharwal |
06/16/2022 |
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** 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. |
POWER OF ATTORNEY
The undersigned as a Section 16 reporting person of Ooma, Inc. (the "Company"),
hereby constitutes and appoints
Jenny C. Yeh and Shig Hamamatsu, and each of them, the undersigned's true and
lawful attorney in fact to:
(1) execute, deliver and file for and on behalf of the undersigned, in the
undersigned's capacity as
an officer and/or director of the Company, Forms 3, 4, and 5 in accordance with
Section 16(a) of the Exchange Act;
(2) do and perform any and all acts for and on behalf of the undersigned which
may be necessary or desirable to
complete and execute any such Form 3, 4, or 5, complete and execute any
amendment or amendments thereto, and timely file
such form with the SEC and any stock exchange or similar authority;
(3) seek or obtain, as the undersigned's representative and on the undersigned's
behalf, information on transactions
in the Company's securities from any third party, including brokers, employee
benefit plan administrators and trustees,
and the undersigned hereby authorizes any such person to release any such
information to the undersigned and approves and
ratifies any such release of information; and
(4) take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney in fact,
may be of benefit to, in the best interest of, or legally required by, the
undersigned, it being understood that the documents executed
by such attorney in fact on behalf of the undersigned pursuant to this Power of
Attorney shall be in such form and shall contain such terms and conditions as
such attorney in fact may approve in such attorney in fact's discretion.
The undersigned hereby grants to each such attorney in fact full power and
authority to do and perform any and every act and
thing whatsoever requisite, necessary, or proper to be done in the exercise of
any of the rights and powers herein granted,
as fully to all intents and purposes as the undersigned might or could do if
personally present, with full power of substitution or
revocation, hereby ratifying and confirming all that such attorney in fact, or
such attorney in fact's substitute or substitutes,
shall lawfully do or cause to be done by virtue of this power of attorney and
the rights and powers herein granted.
The undersigned acknowledges that the foregoing attorneys in fact, in serving in
such capacity at the request of the undersigned,
are not assuming, nor is the Company assuming, any of the undersigned's
responsibilities to comply with Section 16 of the Exchange Act.
The undersigned further acknowledges and agrees that the attorney-in-fact and
the Company are relying on written and
oral information provided by the undersigned to complete such forms and the
undersigned is responsible for reviewing the completed forms
prior to their filing. The attorney-in-fact and the Company are not responsible
for any errors or omissions in such filings.
The attorney-in-fact and the Company are not responsible for determining whether
or not the transactions reported could be matched
with any other transactions for the purpose of determining liability for
short-swing profits under Section 16(b).
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5
with respect to the undersigned's holdings of and transactions in securities
issued by the Company, unless earlier revoked by the undersigned
in a signed writing delivered to the Company and the foregoing attorneys in
fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 2nd day of June, 2022.
/s/Namrata Sabharwal
Signature
Namrata Sabharwal
Print Name