0000899243-20-018179.txt : 20200701 0000899243-20-018179.hdr.sgml : 20200701 20200701194233 ACCESSION NUMBER: 0000899243-20-018179 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200629 FILED AS OF DATE: 20200701 DATE AS OF CHANGE: 20200701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Salem Enrique T CENTRAL INDEX KEY: 0001295402 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38465 FILM NUMBER: 201006647 MAIL ADDRESS: STREET 1: SYMANTEC CORPORATION STREET 2: 20330 STEVENS CREEK BLVD. CITY: CUPERTINO STATE: CA ZIP: 95014 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 doc4.xml FORM 4 SUBMISSION X0306 4 2020-06-29 0 0001261333 DOCUSIGN, INC. DOCU 0001295402 Salem Enrique T C/O BAIN CAPITAL VENTURE INVESTORS, LLC 200 CLARENDON STREET BOSTON MA 02116 1 0 0 0 Common Stock 2020-06-29 4 J 0 613255 0.00 D 2036745 I See Footnotes Common Stock 89811 I See Footnotes Common Stock 78179 D Represents shares of Common Stock held directly by BCIP Venture Associates ("BCIP Venture"), BCIP Venture Associates-B ("BCIP Venture-B"), BCIP Venture Associates II, L.P. ("BCIP Venture II"), BCIP Venture Associates II-B, L.P. ("BCIP Venture II-B"), Bain Capital Venture Fund 2014, L.P. ("Venture Fund 2014"), Bain Capital Venture Partners 2014, L.P. ("Venture Partners 2014"), Bain Capital Venture Coinvestment Fund, L.P. ("Coinvestment Fund") and Bain Capital Venture Coinvestment Partners, L.P. ("Coinvestment Partners" and, collectively, the "Bain Venture Entities"). Bain Capital Venture Investors, LLC ("BCVI") is (i) the general partner of Venture Partners 2014 and Coinvestment Partners, (ii) the ultimate general partner of Venture Fund 2014 and Coinvestment Fund and (iii) governs the investment strategy and decision making process with respect to investments held by each of BCIP Venture, BCIP Venture-B, BCIP Venture II and BCIP Venture II-B. Mr. Salem is a member of the Executive Committee and a Managing Director of BCVI. By virtue of the relationships described in this footnote, Mr. Salem may be deemed to share voting and dispositive power with respect to all of the shares of Common Stock held by the Bain Venture Entities. Mr. Salem disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. On June 29, 2020, certain of the Bain Venture Entities distributed an aggregate of 613,255 shares of Common Stock to one or more partners in pro-rata in-kind distributions without consideration, including an aggregate of 12,685 shares of Common Stock that were distributed to Mr. Salem. Represents shares of Common Stock held directly by NPI Capital, LLC. Mr. Salem is the managing member of NPI Capital, LLC. Includes 12,685 shares of Common Stock received in the distributions referred to in footnote (3) above. /s/ Enrique T. Salem 2020-07-01