SEC Form 4 · accession 0001144204-18-065255
DOCUSIGN, INC. · DOCU
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mary G Meeker
Director
Period of report
Dec 14, 2018
Accepted (ET)
Dec 18, 2018 · 8:51 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001261333
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Dec 14, 2018 | S | 9,646 | $42.98 | D | 11,023 | I | See Footnote |
| Common StockF4 | Dec 18, 2018 | J | 2,288,550 | $0.00 | D | 0 | I | See Footnote |
| Common StockF2 | Dec 18, 2018 | J | 696,032 | $0.00 | A | 707,055 | I | See Footnote |
| Common StockF2 | Dec 18, 2018 | J | 613,357 | $0.00 | D | 93,698 | I | See Footnote |
| Common StockF8 | Dec 18, 2018 | J | 70,036 | $0.00 | A | 124,266 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The price reported in column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $42.93 to $43.02, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in this footnote (1) to this Form 4.
- F2The shares are held directly by KPCB DGF Associates, LLC ("DGF Associates"). The reporting person is a managing member of DGF Associates and may be deemed to share voting and investment power over the securities held by DGF Associates. The reporting person disclaims beneficial ownership over such securities except to the extent of her pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.
- F3Represents a pro-rata in-kind distribution of Common Stock of the Issuer by KPCB Digital Growth Fund, LLC ("KPCB Growth") and KPCB DGF Founders Fund, LLC ("KPCB FF") without consideration to the respective members of each such entity (the "Fund Distribution").
- F4KPCB Holdings, Inc., as nominee, holds the stock for the account of KPCB Growth and KPCB FF. All shares are held for convenience in the name of "KPCB Holdings, Inc., as nominee" for the accounts of such entities who each exercise their own voting and dispositive power of such shares. The reporting person is a managing member of DGF Associates, which is the managing member of KPCB Growth and KPCB FF. The reporting person may be deemed to share voting and investment power over the securities held by KPCB Growth and KPCB FF. The reporting person disclaims beneficial ownership over such securities except to the extent of her pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.
- F5Represents a change in the form of ownership from indirect to direct by virtue of the receipt of shares from KPCB Growth in the Fund Distribution by KPCB Growth.
- F6Represents a pro-rata in-kind distribution of Common Stock of the Issuer by DGF Associates without consideration to its members (the "DGF Associates Distribution").
- F7Represents a change in the form of ownership from indirect to direct by virtue of the receipt of shares in the DGF Associates Distribution.
- F8Shares are held directly by the reporting person.