0001104659-21-138151.txt : 20211112 0001104659-21-138151.hdr.sgml : 20211112 20211112164326 ACCESSION NUMBER: 0001104659-21-138151 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211110 FILED AS OF DATE: 20211112 DATE AS OF CHANGE: 20211112 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MORGENTHALER VENTURE PARTNERS IX LP CENTRAL INDEX KEY: 0001439101 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40508 FILM NUMBER: 211404341 BUSINESS ADDRESS: STREET 1: 2710 SAND HILL ROAD STREET 2: SUITE 100 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-388-7600 MAIL ADDRESS: STREET 1: 2710 SAND HILL ROAD STREET 2: SUITE 100 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Morgenthaler Management Partners IX, LLC CENTRAL INDEX KEY: 0001666860 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40508 FILM NUMBER: 211404340 BUSINESS ADDRESS: STREET 1: 3200 ALPINE ROAD CITY: PORTOLA VALLEY STATE: CA ZIP: 94028 BUSINESS PHONE: 650-388-7600 MAIL ADDRESS: STREET 1: 3200 ALPINE ROAD CITY: PORTOLA VALLEY STATE: CA ZIP: 94028 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Doximity, Inc. CENTRAL INDEX KEY: 0001516513 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING SERVICES [7371] IRS NUMBER: 272485512 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: 500 THIRD STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94107 BUSINESS PHONE: (650) 549-4330 MAIL ADDRESS: STREET 1: 500 THIRD STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94107 4 1 tm2129009-14_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2021-11-10 1 0001516513 Doximity, Inc. DOCS 0001439101 MORGENTHALER VENTURE PARTNERS IX LP 3200 ALPINE ROAD PORTOLA VALLEY CA 94028 0 0 1 0 0001666860 Morgenthaler Management Partners IX, LLC 3200 ALPINE ROAD PORTOLA VALLEY CA 94028 0 0 1 0 Class A Common Stock 2021-11-10 4 C 0 17070350 0 A 17070350 D Class A Common Stock 2021-11-12 4 J 0 8535175 0 D 8535175 D Class B Common Stock 2021-11-10 4 C 0 17070350 0 D Class A Common Stock 17070350 0 D Conversion of a derivative security in accordance of its terms. These shares are directly held by Morgenthaler Venture Partners IX, L.P. ("Morgenthaler"). Morgenthaler Management Partners IX, LLC ("MMP IX") is the sole general partner of Morgenthaler. MMP IX may be deemed to indirectly beneficially own the shares held by Morgenthaler, and MMP IX disclaims beneficial ownership of such shares, except to the extent of its pecuniary interest therein. Represents a pro-rata, in-kind distribution by Morgenthaler and its affiliated funds, not for additional consideration, to MMP IX and its respective members and assignees. Each share of Class B Common Stock is convertible into one share of Class A Common Stock, par value $0.001 per share (the "Class A Common Stock"), at any time at the option of the holder. Each share of Class B Common Stock held by the Reporting Person will automatically convert into one share of Class A Common Stock, upon the following: (1) the sale or transfer of such share of Class B Common Stock, except for certain permitted transfers described in the Issuer's amended and restated certificate of incorporation; (2) the death or incapacity of the Reporting Person; and (3) on the final conversion date, defined as the earlier of (a) the tenth anniversary of the effectiveness of the registration statement in connection with the IPO; or (b) the date specified by a vote of the holders of at least 66 2/3% of the outstanding shares of Class B Common Stock, voting as a single class. MORGENTHALER VENTURE PARTNERS IX, L.P. By: Morgenthaler Management Partners IX, LLC, its General Partner By: /s/ Travis Boettner, Chef Financial Officer and Chief Compliance Officer 2021-11-12 MORGENTHALER MANAGEMENT PARTNERS IX, LLC By: /s/ Travis Boettner, Chef Financial Officer and Chief Compliance Officer 2021-11-12