SEC Form 4 · accession 0001209191-18-027472

DOCUSIGN, INC. · DOCU

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

Reporting owner

Director

Period of report

May 1, 2018

Accepted (ET)

May 2, 2018 · 7:34 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	924	—	A	33,641	I	See footnote
Common Stock^F1,F2	May 1, 2018	C	277	—	A	33,918	I	See footnote
Common Stock^F1,F2	May 1, 2018	C	4,707,896	—	A	4,741,814	I	See footnote
Common Stock^F1,F2	May 1, 2018	C	85,391	—	A	4,827,205	I	See footnote
Common Stock^F1,F2	May 1, 2018	C	17,170	—	A	4,844,375	I	See footnote
Common Stock^F2	May 1, 2018	S	485,122	$29.00	D	4,359,253	I	See footnote

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	924	D	—	—	Common Stock	924	I
Series B-1 Preferred Stock^F3,F1	—	May 1, 2018	C	277	D	—	—	Common Stock	277	I
Series C Preferred Stock^F3,F1	—	May 1, 2018	C	4,707,896	D	—	—	Common Stock	4,707,896	I
Series D Preferred Stock^F3,F1	—	May 1, 2018	C	85,391	D	—	—	Common Stock	85,391	I
Series E Preferred Stock^F3,F1	—	May 1, 2018	C	17,170	D	—	—	Common Stock	17,170	I

F1Each share of Series B Preferred Stock, Series B-1 Preferred Stock, Series C Preferred Stock, Series D Preferred Stock and Series E 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 Scale Venture Partners III, L.P. ("SVP III"). Scale Venture Management III, LLC ("SVM III") is the general partner of SVP III. Rory O'Driscoll, Stacy Bishop, Kate Mitchell and Andrew Vitus, are managing members of SVM III and share voting and dispositive power with respect to the shares held by SVP III. The reporting person disclaims beneficial ownership of the shares except to the extent of his pecuniary interest therein.
F3The shares were held by SVP III. SVM III is the general partner of SVP III. Rory O'Driscoll, Stacy Bishop, Kate Mitchell and Andrew Vitus, are managing members of SVM III and share voting and dispositive power with respect to the shares held by SVP III. The reporting person disclaims beneficial ownership of the shares except to the extent of his pecuniary interest therein.