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DOCU DocuSign Inc

58.31
-1.19 (-2.00%)
After Hours
Last Updated: 00:15:13
Delayed by 15 minutes
Share Name Share Symbol Market Type
DocuSign Inc NASDAQ:DOCU NASDAQ Common Stock
  Price Change % Change Share Price Bid Price Offer Price High Price Low Price Open Price Shares Traded Last Trade
  -1.19 -2.00% 58.31 58.10 58.34 59.98 58.06 59.93 1,517,411 00:15:13

Annual Statement of Changes in Beneficial Ownership (5)

13/03/2020 9:48pm

Edgar (US Regulatory)


FORM 5
[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
[ ] Form 3 Holdings Reported
[ ] Form 4 Transactions Reported UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES

                                                                                  
OMB APPROVAL
OMB Number: 3235-0362
Estimated average burden
hours per response...
1.0                       
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

Wolberg Kirsten O.
2. Issuer Name and Ticker or Trading Symbol

DOCUSIGN, INC. [DOCU]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

_____ Director                    _____ 10% Owner
__X__ Officer (give title below)    _____ Other (specify below)
Chief Technology & Ops Officer
(Last)          (First)          (Middle)

C/O DOCUSIGN, INC.,  221 MAIN STREET, SUITE 1550
3. Statement for Issuer's Fiscal Year Ended (MM/DD/YYYY)
1/31/2020 
(Street)

SAN FRANCISCO, CA 94105
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed(MM/DD/YYYY)
 
6. Individual or Joint/Group Filing(Check Applicable Line)

_X_ Form Filed by One Reporting Person
___ Form Filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date2A. Deemed Execution Date, if any3. Trans. Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Amount(A) or (D)Price
Common Stock 1/10/2020  G 486 D$0 145300 D  
Common Stock 1/10/2020  G (1)486 A$0 486 I By First Child's Trust 
Common Stock 1/10/2020  G 486 D$0 144814 D  
Common Stock 1/31/2020  G (2)486 A$0 486 I By Second Child's Trust 

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security3. Trans. Date3A. Deemed Execution Date, if any4. Trans. Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YYYY)
7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares

Explanation of Responses:
(1) This transaction involved a gift of securities by the Reporting Person to a trust for the benefit of her first child, who shares the Reporting Person's household. The Reporting Person disclaims beneficial ownership of the shares held in the first child's trust, and this report should not be deemed an admission that the Reporting Person is the beneficial owner of the shares held in the trust for purposes of Section 16 or for any other purpose.
(2) This transaction involved a gift of securities by the Reporting Person to a trust for the benefit of her second child, who shares the Reporting Person's household. The Reporting Person disclaims beneficial ownership of the shares held in the second child's trust, and this report should not be deemed an admission that the Reporting Person is the beneficial owner of the shares held in the trust for purposes of Section 16 or for any other purpose.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
Wolberg Kirsten O.
C/O DOCUSIGN, INC.
221 MAIN STREET, SUITE 1550
SAN FRANCISCO, CA 94105


Chief Technology & Ops Officer

Signatures
/s/ Apple Palarca, Attorney-in-fact3/13/2020
**Signature of Reporting PersonDate

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