SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Threshold Ventures I, L.P.

(Last) (First) (Middle)
2882 SAND HILL RD #150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Doximity, Inc. [ DOCS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
11/02/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction 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)
Code V Amount (A) or (D) Price
Class A Common Stock 11/02/2021 C(1) 4,667,276 A (1) 4,667,276 D(2)
Class A Common Stock 11/02/2021 C(1) 518,586 A (1) 518,586 I(3) By Threshold Ventures I Partners Fund, LLC(3)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction 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 (Month/Day/Year) 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 Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Class B Common Stock (4) 11/02/2021 C(1) 4,667,276 (4) (4) Class A Common Stock 4,667,276 $0 0 D(2)
Class B Common Stock (4) 11/02/2021 C(1) 518,586 (4) (4) Class A Common Stock 518,586 $0 0 I(3) By Threshold Ventures I Partners Fund, LLC(3)
1. Name and Address of Reporting Person*
Threshold Ventures I, L.P.

(Last) (First) (Middle)
2882 SAND HILL RD #150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Threshold Ventures I Partners Fund, LLC

(Last) (First) (Middle)
2882 SAND HILL RD #150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Threshold Ventures I General Partner, LLC

(Last) (First) (Middle)
2882 SAND HILL RD #150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Stein Josh

(Last) (First) (Middle)
2882 SAND HILL RD #150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Stavropoulos Andreas

(Last) (First) (Middle)
2882 SAND HILL RD #150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. 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.
2. These shares are directly held by Threshold Ventures I, L.P. ("Threshold I"). Threshold Ventures I General Partner, LLC ("Threshold I GP") is the general partner of Threshold I and may be deemed to have sole voting, investment and dispositive power over the shares held by Threshold I. Threshold I GP may be deemed to have sole voting, investment and dispositive power over the shares held by Threshold I GP. Josh Stein and Andreas Stavropoulos, the managing members of Threshold I GP, may be deemed to have shared voting, investment and dispositive power over such shares. Such individuals and entities disclaim beneficial ownership of such shares except to the extent of their pecuniary interest therein.
3. These shares are directly held by Threshold Ventures I Partners Fund, LLC ("Threshold I Partners"). Josh Stein and Andreas Stavropoulos, the voting members of Threshold I Partners, may be deemed to have shared voting, investment and dispositive power over the shares held by Threshold I Partners. Such individuals disclaim beneficial ownership of such shares except to the extent of their pecuniary interest therein.
4. 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 each 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 such 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.
THRESHOLD VENTURES I, L.P. By: Threshold Ventures I General Partner, LLC, its General Partner By: /s/ Josh Stein, Managing Member 11/03/2021
THRESHOLD VENTURES I PARTNERS FUND, LLC By: /s/ Josh Stein, Voting Member 11/03/2021
THRESHOLD VENTURES I GENERAL PARTNER, LLC By: /s/ Josh Stein, Managing Member 11/03/2021
JOSH STEIN /s/ Josh Stein 11/03/2021
ANDREAS STAVROPOULOS /s/ Andreas Stavropoulos 11/03/2021
** 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 4 (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.
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