0001261333-20-000019.txt : 20200313
0001261333-20-000019.hdr.sgml : 20200313
20200313174722
ACCESSION NUMBER: 0001261333-20-000019
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200131
FILED AS OF DATE: 20200313
DATE AS OF CHANGE: 20200313
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Wolberg Kirsten O.
CENTRAL INDEX KEY: 0001664367
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38465
FILM NUMBER: 20714291
MAIL ADDRESS:
STREET 1: 900 NORTH MCCARTHY BLVD
CITY: MILPITAS
STATE: CA
ZIP: 95035
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 1550
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
BUSINESS PHONE: 415-489-4940
MAIL ADDRESS:
STREET 1: 221 MAIN ST., SUITE 1550
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
FORMER COMPANY:
FORMER CONFORMED NAME: DOCUSIGN INC
DATE OF NAME CHANGE: 20030826
5
1
wf-form5_158413602532925.xml
FORM 5
X0306
5
2020-01-31
0
0
0
0001261333
DOCUSIGN, INC.
DOCU
0001664367
Wolberg Kirsten O.
C/O DOCUSIGN, INC.
221 MAIN STREET, SUITE 1550
SAN FRANCISCO
CA
94105
0
1
0
0
Chief Technology & Ops Officer
Common Stock
2020-01-10
5
G
0
486
0
D
145300
D
Common Stock
2020-01-10
5
G
0
486
0
A
486
I
By First Child's Trust
Common Stock
2020-01-10
5
G
0
486
0
D
144814
D
Common Stock
2020-01-31
5
G
0
486
0
A
486
I
By Second Child's Trust
This transaction involved a gift of securities by the Reporting Person to a trust for the benefit of her first child, who shares the Reporting Person's household. The Reporting Person disclaims beneficial ownership of the shares held in the first child's trust, and this report should not be deemed an admission that the Reporting Person is the beneficial owner of the shares held in the trust for purposes of Section 16 or for any other purpose.
This transaction involved a gift of securities by the Reporting Person to a trust for the benefit of her second child, who shares the Reporting Person's household. The Reporting Person disclaims beneficial ownership of the shares held in the second child's trust, and this report should not be deemed an admission that the Reporting Person is the beneficial owner of the shares held in the trust for purposes of Section 16 or for any other purpose.
/s/ Apple Palarca, Attorney-in-fact
2020-03-13