SEC Form 4 · accession 0001209191-18-027187

DOCUSIGN, INC. · DOCU

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Mary G Meeker

Director

Period of report

May 1, 2018

Accepted (ET)

May 1, 2018 · 6:26 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 Stock^F1,F2	May 1, 2018	C	1,166,533	—	A	1,903,785	I	See footnote
Common Stock^F1,F2	May 1, 2018	C	351,524	—	A	2,255,309	I	See footnote
Common Stock^F1,F2	May 1, 2018	C	55,126	—	A	2,310,435	I	See footnote
Common Stock^F1,F2	May 1, 2018	C	1,122,390	—	A	3,432,825	I	See footnote

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	D/I
Series B Preferred Stock^F3,F1	—	May 1, 2018	C	1,166,533	D	—	—	Common Stock	1,166,533	I
Series B-1 Preferred Stock^F3,F1	—	May 1, 2018	C	351,524	D	—	—	Common Stock	351,524	I
Series C Preferred Stock^F3,F1	—	May 1, 2018	C	55,126	D	—	—	Common Stock	55,126	I
Series D Preferred Stock^F3,F1	—	May 1, 2018	C	1,122,390	D	—	—	Common Stock	1,122,390	I

Explanation of responses

F1Each share of Series B Preferred Stock, Series B-1 Preferred Stock, 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.
F2The reporting person is a managing member of KPCB DGF Associates, LLC, which is the managing member of KPCB Digital Growth Fund, LLC ("KPCB Growth") and KPCB DGF Founders Fund, LLC ("KPCB FF"). KPCB Holdings, Inc., as nominee, holds the stock for the account 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.
F3The reporting person is a managing member of KPCB DGF Associates, LLC, which is the managing member of KPCB Growth and KPCB FF. KPCB Holdings, Inc., as nominee, held the stock for the account 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.