SEC Form 4 · accession 0001209191-19-005255
DOCUSIGN, INC. · DOCU
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Scott V. Olrich
Officer — Chief Strategy and Marketing
Period of report
Jan 22, 2019
Accepted (ET)
Jan 24, 2019 · 8:24 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 Stock | Jan 22, 2019 | M | 220,000 | $0.00 | A | 545,628 | D | |
| Common Stock | Jan 22, 2019 | F | 109,212 | $45.85 | D | 436,416 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Performance Stock UnitsF2 | — | Jan 22, 2019 | M | 220,000 | D | — | — | Common Stock | 220,000 | 220,000 | D |
Explanation of responses
- F1Represents shares withheld by the issuer to satisfy a tax obligation realized by the reporting person upon the vesting and settlement of performance stock units.
- F2Represents shares issuable on settlement of performance stock units ("PSUs") granted to the reporting person. Each PSU represents a contingent right to receive one share of Issuer's Common Stock. The PSUs vest subject to the achievement of certain performance conditions involving the Issuer's stock price.