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