SEC FORM 3

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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1. Name and Address of Reporting Person^*

Matheos Mark

(Last)

(First)

(Middle)

7950 JONES BRANCH DRIVE

(Street)

MCLEAN

22102

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
12/31/2021

3. Issuer Name and Ticker or Trading Symbol
APPIAN CORP [ APPN ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
Chief Accounting 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)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	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)
Employee Stock Option (Right to Buy)	04/25/2022	04/25/2027	Class B Common Stock	4,020	12	D
Restricted Stock Unit	⁽¹⁾⁽²⁾	⁽¹⁾	Class A Common Stock	20	⁽¹⁾	D
Restricted Stock Unit	⁽¹⁾⁽³⁾	⁽¹⁾	Class A Common Stock	40	⁽¹⁾	D
Restricted Stock Unit	⁽¹⁾⁽⁴⁾	⁽¹⁾	Class A Common Stock	3,393	⁽¹⁾	D
Restricted Stock Unit	⁽¹⁾⁽⁵⁾	⁽¹⁾	Class A Common Stock	3,764	⁽¹⁾	D

Explanation of Responses:

1. Each RSU represents a contingent right to receive one share of Issuer's Class A Common Stock (or its cash equivalent, at the discretion of the Issuer).

2. The RSUs were granted on October 25, 2017 and vest on November 5, 2022, provided that the Reporting Person has provided continuous service to the Issuer through the vesting date.

3. The RSUs were granted on April 27, 2018 and vest in two equal installments on each of May 5, 2022 and May 5, 2023, provided that the Reporting Person has provided continuous service to the Issuer through the vesting date.

4. The RSUs were granted on October 29, 2019 and vest in three equal installments on each of November 5, 2022, November 5, 2023 and November 5, 2024, provided that the Reporting Person has provided continuous service to the Issuer through the vesting date.

5. The RSUs were granted on May 4, 2021 and vest in four equal annual installments commencing on May 5, 2022, provided that the Reporting Person has provided continuous service to the Issuer through the vesting date.

Remarks:

	/s/ Angela Patterson, Attorney-in-Fact	01/10/2022
	** 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.

SEC Form 3 filed by new insider Matheos Mark