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*
Babcoke Jason

(Last) (First) (Middle)
C/O SILVER LAKE
2775 SAND HILL ROAD, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/27/2016
3. Issuer Name and Ticker or Trading Symbol
BLACKLINE, INC. [ BL ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
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
Explanation of Responses:
Remarks:
Exhibit 24.1 - Power of Attorney Mr. Babcoke is a Principal at Silver Lake Sumeru and is a member of the board of directors of BlackLine, Inc. (the "Issuer"). Certain affiliates of Silver Lake Sumeru have filed a separate Form 3 reporting securities of the Issuer that they may be deemed to beneficially own. Mr. Babcoke disclaims beneficial ownership of any securities of the Issuer that may be deemed to be beneficially owned by affiliates of Silver Lake Sumeru.
No securities are beneficially owned.
/s/ Jason Babcoke 10/27/2016
** 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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                                   Exhibit 24
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              LIMITED POWER OF ATTORNEY - SECURITIES LAW COMPLIANCE


     The undersigned, as an officer or director of BlackLine, Inc. (the
"Corporation"), hereby constitutes and appoints Karen M. King and Andrew J.
Schader, each the undersigned's true and lawful attorney-in-fact and agent to
complete and execute such Forms 144, Form ID, Forms 3, 4 and 5 and other forms
as such attorney shall in his or her discretion determine to be required or
advisable pursuant to Rule 144 promulgated under the Securities Act of 1933, as
amended, Section 16 of the Securities Exchange Act of 1934, as amended, and the
rules and regulations promulgated thereunder, or any successor laws and
regulations, as a consequence of the undersigned's ownership, acquisition or
disposition of securities of the Corporation, and to do all acts necessary in
order to file such forms with the Securities and Exchange Commission, any
securities exchange or national association, the Corporation and such other
person or agency as the attorney shall deem appropriate.

     The undersigned hereby ratifies and confirms all that said
attorneys-in-fact and agents shall do or cause to be done by virtue hereof. 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 Securities Exchange Act of 1934 (as amended).

     This Limited 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
Corporation unless earlier revoked by the undersigned in a writing delivered to
the foregoing attorneys-in-fact.

     This Limited Power of Attorney is executed as of the date set forth below.

                                      Signature:       /s/ Jason Babcoke
                                                 -------------------------------

                                      Print Name: Jason Babcoke
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                                      Dated: October 19, 2016
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