SEC FORM 3

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

Roberts Jonathan David

(Last)

(First)

(Middle)

C/O IGNITION PARTNERS

350 106TH AVE. NE, 1ST FLOOR

(Street)

BELLEVUE

98004

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
04/26/2018

3. Issuer Name and Ticker or Trading Symbol
DOCUSIGN INC [ DOCU ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

5. If Amendment, Date of Original Filed (Month/Day/Year)

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 Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock	106,428	I	See footnote⁽¹⁾

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Series A Preferred Stock	⁽²⁾	⁽²⁾	Common Stock	2,601,373	⁽²⁾	I	See footnote⁽³⁾
Series A-1 Preferred Stock	⁽⁴⁾	⁽⁴⁾	Common Stock	1,264,222	⁽⁴⁾	I	See footnote⁽⁵⁾
Series B Preferred Stock	⁽⁶⁾	⁽⁶⁾	Common Stock	8,546,742	⁽⁶⁾	I	See footnote⁽⁷⁾
Series B-1 Preferred Stock	⁽⁸⁾	⁽⁸⁾	Common Stock	1,392,050	⁽⁸⁾	I	See footnote⁽⁹⁾
Series C Preferred Stock	⁽¹⁰⁾	⁽¹⁰⁾	Common Stock	1,533,237	⁽¹⁰⁾	I	See footnote⁽¹¹⁾
Series D Preferred Stock	⁽¹²⁾	⁽¹²⁾	Common Stock	195,759	⁽¹²⁾	I	See footnote⁽¹³⁾

Explanation of Responses:

1. Includes 101,127 shares held by Ignition Venture Partners II, L.P. and 5,301 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. The reporting person disclaims beneficial ownership of the reported shares except to the extent of his pecuniary interest therein.

2. The Series A Preferred Stock is convertible, at the option of the holder, into shares of Common Stock on a 1.02192925205-for-1 basis and will automatically convert into shares of Common Stock on a 1.02192925205-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series A Preferred Stock does not have an expiration date.

3. Includes 2,471,825 shares held by Ignition Venture Partners II, L.P. and 129,548 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. The reporting person disclaims beneficial ownership of the reported shares except to the extent of his pecuniary interest therein.

4. The Series A-1 Preferred Stock is convertible, at the option of the holder, into shares of Common Stock on a 1-for-1 basis and will automatically convert into shares of Common Stock on a 1-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series A-1 Preferred Stock does not have an expiration date.

5. Includes 1,201,264 shares held by Ignition Venture Partners II, L.P. and 62,958 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. The reporting person disclaims beneficial ownership of the reported shares except to the extent of his pecuniary interest therein.

6. The Series B Preferred Stock is convertible, at the option of the holder, into shares of Common Stock on a 1-for-1 basis and will automatically convert into shares of Common Stock on a 1-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series B Preferred Stock does not have an expiration date.

7. Includes 8,121,116 shares held by Ignition Venture Partners II, L.P. and 425,626 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. The reporting person disclaims beneficial ownership of the reported shares except to the extent of his pecuniary interest therein.

8. The Series B-1 Preferred Stock is convertible, at the option of the holder, into shares of Common Stock on a 1-for-1 basis and will automatically convert into shares of Common Stock on a 1-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series B-1 Preferred Stock does not have an expiration date.

9. Includes 1,322,726 shares held by Ignition Venture Partners II, L.P. and 69,324 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. The reporting person disclaims beneficial ownership of the reported shares except to the extent of his pecuniary interest therein.

10. The Series C Preferred Stock is convertible, at the option of the holder, into shares of Common Stock on a 1-for-1 basis and will automatically convert into shares of Common Stock on a 1-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series C Preferred Stock does not have an expiration date.

11. Includes 1,456,883 shares held by Ignition Venture Partners II, L.P. and 76,354 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. The reporting person disclaims beneficial ownership of the reported shares except to the extent of his pecuniary interest therein.

12. The Series D Preferred Stock is convertible, at the option of the holder, into shares of Common Stock on a 1-for-1 basis and will automatically convert into shares of Common Stock on a 1-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series D Preferred Stock does not have an expiration date.

13. Includes 186,010 shares held by Ignition Venture Partners II, L.P. and 9,749 shares held by Ignition Managing Directors Fund II, LLC. Ignition GP II, LLC possesses all voting and dispositive power with respect to shares held by Ignition Venture Partners II, L.P. A board of nine managing directors controls all voting and dispositive power with respect to Ignition GP II, LLC, including with respect to shares held by Ignition Venture Partners II, L.P. and Ignition Managing Directors Fund II, LLC. The board is comprised of Jonathan Roberts, Jon Anderson, John Connors, Robert Headley, Steve Hooper, Cameron Myhrvold, Brad Silverberg, Rich Tong and John Zagula. The reporting person disclaims beneficial ownership of the reported shares except to the extent of his pecuniary interest therein.

Remarks:

	/s/ Yanira Wong, Attorney-in-fact	04/26/2018
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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