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*
Chung Bora

(Last) (First) (Middle)
C/O BILL.COM HOLDINGS, INC.
1810 EMBARCADERO ROAD

(Street)
PALO ALTO CA 94303

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
12/11/2019
3. Issuer Name and Ticker or Trading Symbol
Bill.com Holdings, Inc. [ BILL ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP of Products
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)
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)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (Right to Buy) (1) 02/12/2029 Common Stock 375,000 $8.75 D
Employee Stock Option (Right to Buy) (2) 05/14/2029 Common Stock 50,000 $11.2 D
Explanation of Responses:
1. This option vested 25% of the total shares on December 10, 2019 and thereafter 1/48th of the total shares vest monthly until such time as the option is 100% vested, subject to the continuing service of the Reporting Person on each vesting date.
2. This option vested 1/48th of the total shares monthly beginning June 15, 2019 until such time as the option is 100% vested, subject to the continuing service of the Reporting Person on each vesting date.
Remarks:
Exhibit 24.1 - Power of Attorney
/s/ Rajesh Aji, Attorney-in-Fact 12/11/2019
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.