0001261333-21-000229.txt : 20211216 0001261333-21-000229.hdr.sgml : 20211216 20211216181526 ACCESSION NUMBER: 0001261333-21-000229 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211215 FILED AS OF DATE: 20211216 DATE AS OF CHANGE: 20211216 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: 211499018 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_163969650834874.xml FORM 4 X0306 4 2021-12-15 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 2021-12-15 4 M 0 4219 0 A 15611 D Common Stock 2021-12-15 4 F 0 2092 144.46 D 13519 D Restricted Stock Units 2021-12-15 4 M 0 3019 0 D Common Stock 3019.0 33212 D Restricted Stock Units 2021-12-15 4 M 0 1200 0 D Common Stock 1200.0 16802 D Represents shares withheld by the Issuer to satisfy a tax obligation realized by the Reporting Person upon the vesting and settlement of restricted stock units ("RSU"). Each RSU represents a contingent right to receive one share of common stock of the Issuer upon vesting. The RSUs will vest 25% over the first year, while the remaining will vest in equal quarterly installments over four years, with a vesting commencement date of September 10, 2020, in each case subject to the Reporting Person being a service provider through each such date. The restricted stock units 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. The RSUs will vest in equal quarterly installments over four years, with a vesting commencement date of May 10, 2021, in each case subject to the Reporting Person being a service provider through each such date. The restricted stock units 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. /s/ Brian Kelly, Attorney-in-fact 2021-12-16