SEC Form 4 · accession 0001209191-18-027185
DOCUSIGN, INC. · DOCU
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Louis J Lavigne Jr.
Director
Period of report
May 1, 2018
Accepted (ET)
May 1, 2018 · 6:23 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 | 8,981 | — | A | 35,633 | D | |
| Common StockF1 | May 1, 2018 | C | 44,905 | — | A | 44,905 | I | By Trust |
| Common StockF1,F2 | May 1, 2018 | C | 35,924 | — | A | 47,346 | I | See footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series D Preferred StockF1 | — | May 1, 2018 | C | 8,981 | D | — | — | Common Stock | 8,981 | 0 | D |
| Series D Preferred StockF1 | — | May 1, 2018 | C | 44,905 | D | — | — | Common Stock | 44,905 | 0 | I |
| Series D Preferred StockF3,F1 | — | May 1, 2018 | C | 35,924 | D | — | — | Common Stock | 35,924 | 0 | I |
Explanation of responses
- F1Each share of 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.
- F2The shares are held by Spring Development Group, LLC. The reporting person is the managing member of Spring Development Group, LLC and has sole voting and dispositive power over the shares held by Spring Development Group, LLC.
- F3The shares were held by Spring Development Group, LLC. The reporting person is the managing member of Spring Development Group, LLC and has sole voting and dispositive power over the shares held by Spring Development Group, LLC.