SEC Form 4 · accession 0001209191-18-027184
DOCUSIGN, INC. · DOCU
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Keith J. Krach
Director
Period of report
May 1, 2018
Accepted (ET)
May 1, 2018 · 6:21 pm EDT
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 | May 1, 2018 | C | 299,593 | — | A | 619,593 | I | By Trusts |
| Common StockF1 | May 1, 2018 | C | 52,374 | — | A | 671,967 | I | By Trusts |
| Common Stock | May 1, 2018 | S | 165,026 | $29.00 | D | 7,589,850 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series C Preferred StockF1 | — | May 1, 2018 | C | 299,593 | D | — | — | Common Stock | 299,593 | 0 | I |
| Series D Preferred StockF1 | — | May 1, 2018 | C | 52,374 | D | — | — | Common Stock | 52,374 | 0 | I |
Explanation of responses
- F1Each share of Series C Preferred Stock and Series D Preferred Stock converted into one share of common stock upon the closing of the Issuer's initial public offering. The shares had no expiration date.