Form: 3

Initial statement of beneficial ownership of securities

October 31, 2017

Documents

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*
Checketts Nathaniel L.
(Last) (First) (Middle)
C/O VERITONE, INC.
575 ANTON BOULEVARD
(Street)
COSTA MESA CA 92626
(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/11/2017 		3. Issuer Name and Ticker or Trading Symbol
Veritone, Inc. [ VERI ]
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
Stock Option (Right to Buy) (1) 04/14/2026 Common Stock 15,000 1.5 D
Explanation of Responses:
1. The option shares vest in 48 equal monthly installments commencing on August 7, 2014.
Remarks:
Due to an administrative error, this Form 3 was not filed on May 11, 2017 (the effective date of the issuer's IPO), and has already been supplemented by a Form 4 filed on May 15, 2017 to reflect the reporting person's subsequent restricted stock unit award granted on May 11, 2017. As such, this Form 3 should be read in conjunction with the foregoing Form 4.
/s/ Ellen S. Bancroft, Attorney-in-Fact 10/31/2017
** 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.