0001516513-21-000022.txt : 20210820 0001516513-21-000022.hdr.sgml : 20210820 20210820175355 ACCESSION NUMBER: 0001516513-21-000022 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210818 FILED AS OF DATE: 20210820 DATE AS OF CHANGE: 20210820 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kleine Joseph B. CENTRAL INDEX KEY: 0001511114 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40508 FILM NUMBER: 211194803 MAIL ADDRESS: STREET 1: 1100 PARK PLACE STREET 2: SUITE 300 CITY: SAN MATEO STATE: CA ZIP: 94403 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Doximity, Inc. CENTRAL INDEX KEY: 0001516513 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING SERVICES [7371] IRS NUMBER: 272485512 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: 500 THIRD STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94107 BUSINESS PHONE: (650) 549-4330 MAIL ADDRESS: STREET 1: 500 THIRD STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94107 4 1 wf-form4_162949641124391.xml FORM 4 X0306 4 2021-08-18 0 0001516513 Doximity, Inc. DOCS 0001511114 Kleine Joseph B. DOXIMITY, INC. 500 THIRD STREET SAN FRANCISCO CA 94107 0 1 0 0 Chief Commercial Officer Stock Option (Right to Buy) 0.57 2021-08-18 4 J 0 140000 0 D 2026-02-23 Class B Common Stock 140000.0 140000 D Stock Option (Right to Buy) 0.72 2021-08-18 4 J 0 35000 0 D 2026-11-08 Class B Common Stock 35000.0 35000 D Stock Option (Right to Buy) 0.72 2021-08-18 4 J 0 80000 0 D 2027-02-27 Class B Common Stock 80000.0 80000 D Stock Option (Right to Buy) 0.57 2021-08-18 4 J 0 6400 0 D 2026-03-20 Class B Common Stock 6400.0 6400 D Stock Option (Right to Buy) 0.72 2021-08-18 4 J 0 8000 0 D 2027-03-27 Class B Common Stock 8000.0 8000 D Stock Option (Right to Buy) 0.97 2021-08-18 4 J 0 183322 0 D 2028-03-18 Class B Common Stock 183322.0 196678 D Stock Option (Right to Buy) 0.97 2021-08-18 4 J 0 4000 0 D 2028-03-28 Class B Common Stock 4000.0 4000 D Stock Option (Right to Buy) 1.09 2021-08-18 4 J 0 145626 0 D 2029-02-12 Class B Common Stock 145626.0 114374 D Stock Option (Right to Buy) 1.09 2021-08-18 4 J 0 94922 0 D 2029-02-12 Class B Common Stock 94922.0 215078 D Stock Option (Right to Buy) 1.54 2021-08-18 4 J 0 35000 0 D 2030-06-09 Class B Common Stock 35000.0 105000 D Stock Option (Right to Buy) 1.54 2021-08-18 4 J 0 50000 0 D 2030-06-09 Class B Common Stock 50000.0 20000 D Represents shares subject to the stock option transferred to the Reporting Person's former spouse pursuant to a divorce decree. The Reporting Person no longer reports as beneficially owned any securities owned by his former spouse. In the event there is a change of control and the Issuer terminates the Reporting Person's employment other than for cause or the Reporting Person terminates his employment with the Issuer as a result of a constructive termination, in either case within 12 months following the consummation of a change of control, 100% of the then-unvested shares subject to the stock option shall vest and become exercisable as of such termination date. The stock option vested as to 1/4th of the shares subject to the stock option on February 22, 2017 and the remaining shares vested in 36 equal monthly installments thereafter, subject to the Reporting Person's continuous service relationship with the Issuer through each applicable vesting date. The stock option was granted on February 24, 2016 and became fully vested on February 22, 2020. Each share of Class B Common Stock, par value $0.001 per share (the "Class B Common Stock"), is convertible into one share of Class A Common Stock, par value $0.001 per share (the "Class A Common Stock"), at any time at the option of the holder. Each share of Class B Common Stock held by the Reporting Person will automatically convert into one share of Class A Common Stock, upon the following: (1) the sale or transfer of such share of Class B Common Stock, except for certain permitted transfers described in the Issuer's amended and restated certificate of incorporation; (2) the death or incapacity of the Reporting Person; and (3) on the final conversion date, defined as the earlier of (a) the tenth anniversary of the effectiveness of the registration statement in connection with the Issuer's initial public offering; or (b) the date specified by a vote of the holders of at least 66 2/3% of the outstanding shares of Class B Common Stock, voting as a single class. The stock option vested in 48 equal monthly installments after November 9, 2016, subject to the Reporting Person's continuous service relationship with the Issuer through each applicable vesting date. The stock option was granted on November 9, 2016 and became fully vested on November 9, 2020. The stock option vested in 48 equal monthly installments after February 28, 2017, subject to the Reporting Person's continuous service relationship with the Issuer through each applicable vesting date. The stock option was granted on February 28, 2017 and became fully vested on February 28, 2021. The stock option vested subject to a time-based and performance-based vesting schedule. The stock option vested in part upon the achievement of certain performance goals in 2016 and 2017. Upon determination by the Issuer's Board of Directors (the "Board") that such performance goals were met, the stock option vested in 12 equal monthly installments after March 28, 2017, subject to the Reporting Person's continuous service relationship with the Issuer through each applicable vesting date. The stock option was granted on March 21, 2016 and became fully vested on March 28, 2018. The stock option vested in 12 equal monthly installments following the achievement of certain performance goals in calendar year 2017, subject to the Reporting Person's continuous service relationship with the Issuer through each applicable vesting date. The stock option was granted on March 28, 2017 and became fully vested on March 19, 2019. The stock option vests in 48 equal monthly installments after March 19, 2018, subject to the Reporting Person's continuous service relationship with the Issuer through each applicable vesting date. The stock option was granted on March 19, 2018. The stock option vested in full upon the achievement of certain performance goals in calendar year 2018 and calendar year 2019, subject to the Reporting Person's continuous service relationship with the Issuer through each applicable vesting date. The stock option was granted on March 29, 2018 and became fully vested on February 13, 2019. The stock option vests in 48 equal monthly installments after February 28, 2019, subject to the Reporting Person's continuous service relationship with the Issuer through each applicable vesting date. The stock option was granted on February 13, 2019. The stock option vests in 48 equal monthly installments following the date that the target milestone related to the achievement of a certain annual contract value in fiscal 2020 was achieved, subject to the Reporting Person's continuous service relationship with the Issuer through each applicable vesting date. The stock option was granted on February 13, 2019. In the event that the Issuer terminates the Reporting Person's employment without cause, the then-unvested shares subject to the stock option that would have vested during the six months following the Reporting Person's termination will vest and become exercisable. The stock option vests in 48 equal monthly installments after May 1, 2020, subject to the Reporting Person's continuous service relationship with the Issuer through each applicable vesting date. The stock option was granted on June 10, 2020. The stock option shall fully vest upon the date that the Board determines that certain target milestones related to the Issuer's bookings plan have been achieved, subject to the Reporting Person's continuous service relationship with the Issuer through each applicable vesting date. In the event that the target milestones are not achieved on or before March 31, 2021, or if the Board does not otherwise determine that the stock option shall vest in whole or in part on or prior to June 30, 2021, the stock option shall expire. The stock option was granted on June 10, 2020. /s/ Jennifer Chaloemtiarana, Attorney-in-Fact 2021-08-20