0001516513-21-000032.txt : 20211116 0001516513-21-000032.hdr.sgml : 20211116 20211116171113 ACCESSION NUMBER: 0001516513-21-000032 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211112 FILED AS OF DATE: 20211116 DATE AS OF CHANGE: 20211116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Benjamin Regina M. CENTRAL INDEX KEY: 0001594511 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40508 FILM NUMBER: 211417233 MAIL ADDRESS: STREET 1: 51 SAWYER ROAD, SUITE 200 CITY: WALTHAM STATE: MA ZIP: 02453 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 wf-form4_163710065007383.xml FORM 4 X0306 4 2021-11-12 0 0001516513 Doximity, Inc. DOCS 0001594511 Benjamin Regina M. C/O DOXIMITY, INC. 500 THIRD STREET SAN FRANCISCO CA 94107 1 0 0 0 Class A Common Stock 2021-11-12 4 C 0 105862 A 105862 D Class A Common Stock 2021-11-12 4 S 0 82500 74.6687 D 23362 D Class A Common Stock 2021-11-12 4 S 0 22362 75.7034 D 1000 D Class A Common Stock 2021-11-12 4 S 0 1000 75.0186 D 0 D Stock Option (Right to Buy) 2.21 2021-11-12 4 M 0 104862 0 D 2030-09-01 Class B Common Stock 104862.0 431138 D Stock Option (Right to Buy) 1.05 2021-11-12 4 M 0 1000 0 D 2028-06-05 Class B Common Stock 1000.0 0 D Class B Common Stock 2021-11-12 4 M 0 104862 0 A Class A Common Stock 104862.0 104862 D Class B Common Stock 2021-11-12 4 M 0 1000 0 A Class A Common Stock 1000.0 105862 D Class B Common Stock 2021-11-12 4 C 0 105862 0 D Class A Common Stock 105862.0 0 D Each share of Class B Common Stock, par value $0.001 per share (the "Class B Common Stock"), converted into one share of Class A Common Stock, par value $0.001 per share (the "Class A Common Stock"), at the option of the holder. The price represents the weighted-average price of the shares sold in multiple transactions ranging from $75.0000 to $75.9900 per share, inclusive. The Reporting Person undertakes to provide the Issuer, a security holder of the Issuer, or the Staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. The price represents the weighted-average price of the shares sold in multiple transactions ranging from $76.0000 to $76.1800 per share, inclusive. The Reporting Person undertakes to provide the Issuer, a security holder of the Issuer, or the Staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. The stock option vests in 36 equal monthly installments after September 2, 2020, subject to the Reporting Person's continuous service relationship with the Issuer through each applicable vesting date. The stock option was granted on September 2, 2020. Each share of Class B Common Stock is convertible into one share of 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 Issuer's initial public offering; 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. The stock option was granted on June 6, 2018 and fully vested as of such date. /s/ Jennifer Chaloemtiarana, Attorney-in-Fact 2021-11-16