0001209191-18-027188.txt : 20180501 0001209191-18-027188.hdr.sgml : 20180501 20180501182930 ACCESSION NUMBER: 0001209191-18-027188 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180501 FILED AS OF DATE: 20180501 DATE AS OF CHANGE: 20180501 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Roberts Jonathan David CENTRAL INDEX KEY: 0001736120 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38465 FILM NUMBER: 18796917 MAIL ADDRESS: STREET 1: C/O DOCUSIGN, INC., 221 MAIN ST. STREET 2: SUITE 1000 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DOCUSIGN INC CENTRAL INDEX KEY: 0001261333 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 912183967 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 221 MAIN ST., SUITE 1000 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: 866-219-4318 MAIL ADDRESS: STREET 1: 221 MAIN ST., SUITE 1000 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2018-05-01 0 0001261333 DOCUSIGN INC DOCU 0001736120 Roberts Jonathan David C/O IGNITION PARTNERS 350 106TH AVE. NE, 1ST FLOOR BELLEVUE WA 98004 1 0 0 0 Common Stock 2018-05-01 4 C 0 2658418 A 2764846 I See footnote Common Stock 2018-05-01 4 C 0 1264222 A 4029068 I See footnote Common Stock 2018-05-01 4 C 0 8546742 A 12575810 I See footnote Common Stock 2018-05-01 4 C 0 1392050 A 13967860 I See footnote Common Stock 2018-05-01 4 C 0 1533237 A 15501097 I See footnote Common Stock 2018-05-01 4 C 0 195759 A 15696856 I See footnote Common Stock 2018-05-01 4 S 0 784843 29.00 D 14912013 I See footnote Series A Preferred Stock 2018-05-01 4 C 0 2601373 0.00 D Common Stock 2658418 0 I See footnote Series A-1 Preferred Stock 2018-05-01 4 C 0 1264222 0.00 D Common Stock 1264222 0 I See footnote Series B Preferred Stock 2018-05-01 4 C 0 8546742 0.00 D Common Stock 8546742 0 I See footnote Series B-1 Preferred Stock 2018-05-01 4 C 0 1392050 0.00 D Common Stock 1392050 0 I See footnote Series C Preferred Stock 2018-05-01 4 C 0 1533237 0.00 D Common Stock 1533237 0 I See footnote Series D Preferred Stock 2018-05-01 4 C 0 195759 0.00 D Common Stock 195759 0 I See footnote Each share of Series A Preferred Stock converted into 1.02192925205 shares of common stock upon the closing of the Issuer's initial public offering. The shares had no expiration date. Includes 2,627,157 shares held by Ignition Venture Partners II, L.P. and 137,689 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. Each share of Series A-1 Preferred Stock, 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. Includes 3,828,421 shares held by Ignition Venture Partners II, L.P. and 200,647 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. Includes 11,949,537 shares held by Ignition Venture Partners II, L.P. and 626,273 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. Includes 13,272,263 shares held by Ignition Venture Partners II, L.P. and 695,597 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. Includes 14,729,146 shares held by Ignition Venture Partners II, L.P. and 771,951 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. Includes 14,915,156 shares held by Ignition Venture Partners II, L.P. and 781,700 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. Includes 39,085 shares sold by Ignition Managing Directors Fund II, LLC and 745,758 shares sold by Ignition Venture Partners II, L.P. Includes 14,169,398 shares held by Ignition Venture Partners II, L.P. and 742,615 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. The shares were held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. /s/ Yanira Wong, Attorney-in-fact 2018-05-01