0001261333-21-000216.txt : 20211206 0001261333-21-000216.hdr.sgml : 20211206 20211206194207 ACCESSION NUMBER: 0001261333-21-000216 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211205 FILED AS OF DATE: 20211206 DATE AS OF CHANGE: 20211206 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gaylor Cynthia CENTRAL INDEX KEY: 0001737543 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38465 FILM NUMBER: 211474351 MAIL ADDRESS: STREET 1: C/O PIVOTAL SOFTWARE, INC. STREET 2: 875 HOWARD STREET, FIFTH FLOOR CITY: SAN FRANCISCO STATE: CA ZIP: 94103 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 4 1 wf-form4_163883771223790.xml FORM 4 X0306 4 2021-12-05 0 0001261333 DOCUSIGN, INC. DOCU 0001737543 Gaylor Cynthia C/O DOCUSIGN, INC. 221 MAIN STREET, SUITE 1550 SAN FRANCISCO CA 94105 0 1 0 0 Chief Financial Officer Common Stock 2021-12-05 4 M 0 804 0 A 11557 D Common Stock 2021-12-05 4 F 0 165 135.09 D 11392 D Restricted Stock Units 2021-12-05 4 M 0 804 0 D Common Stock 804.0 0 D Each restricted stock unit ("RSU") represents a contingent right to receive one share of the Issuer's common stock. The RSUs will vest in twelve equal quarterly installments over three years, with a vesting commencement date of December 5, 2018, in each case subject to the Reporting Person being a service provider through each such date. The RSUs are subject to accelerated vesting in the event of a termination of employment of the Reporting Person including under certain circumstances following a change in control of the Issuer. The RSUs do not expire; they either vest or are canceled prior to vesting date. /s/ Brian Kelly, Attorney-in-fact 2021-12-06