0001209191-18-027185.txt : 20180501
0001209191-18-027185.hdr.sgml : 20180501
20180501182307
ACCESSION NUMBER: 0001209191-18-027185
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: LAVIGNE LOUIS J JR
CENTRAL INDEX KEY: 0001214127
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38465
FILM NUMBER: 18796889
MAIL ADDRESS:
STREET 1: C/O ALLERGAN, INC.
STREET 2: 2525 DUPONT DRIVE
CITY: IRVINE
STATE: CA
ZIP: 92612
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
0001214127
LAVIGNE LOUIS J JR
C/O DOCUSIGN, INC.
221 MAIN ST., SUITE 1000
SAN FRANCISCO
CA
94105
1
0
0
0
Common Stock
2018-05-01
4
C
0
8981
A
35633
D
Common Stock
2018-05-01
4
C
0
44905
A
44905
I
By Trust
Common Stock
2018-05-01
4
C
0
35924
A
47346
I
See footnote
Series D Preferred Stock
2018-05-01
4
C
0
8981
0.00
D
Common Stock
8981
0
D
Series D Preferred Stock
2018-05-01
4
C
0
44905
0.00
D
Common Stock
44905
0
I
By Trust
Series D Preferred Stock
2018-05-01
4
C
0
35924
0.00
D
Common Stock
35924
0
I
See footnote
Each share of 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.
The shares are held by Spring Development Group, LLC. The reporting person is the managing member of Spring Development Group, LLC and has sole voting and dispositive power over the shares held by Spring Development Group, LLC.
The shares were held by Spring Development Group, LLC. The reporting person is the managing member of Spring Development Group, LLC and has sole voting and dispositive power over the shares held by Spring Development Group, LLC.
/s/ Yanira Wong, Attorney-in-fact
2018-05-01