Enrique T Salem Form 3 DOCUSIGN / Enrique T Salem ownership change

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

OMB APPROVAL

OMB Number:			3235-0104
Estimated average burden
hours per response:			0.5

1. Name and Address of Reporting Person^*

Salem Enrique T

(Last)

(First)

(Middle)

C/O BAIN CAPITAL VENTURE INVESTORS, LLC

200 CLARENDON STREET

(Street)

BOSTON

02116

(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	57,111	D

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)
Redeemable Convertible Series B Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	18,498	⁽¹⁾	I	See footnotes⁽⁴⁾⁽⁵⁾
Redeemable Convertible Series B-1 Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	5,541	⁽¹⁾	I	See footnotes⁽⁴⁾⁽⁵⁾
Redeemable Convertible Series D Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	1,916,890	⁽¹⁾	I	See footnotes⁽⁴⁾⁽⁵⁾
Redeemable Convertible Series D Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	89,811	⁽¹⁾	I	See footnote⁽⁶⁾
Redeemable Convertible Series E Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	343,417	⁽¹⁾	I	See footnotes⁽⁴⁾⁽⁵⁾
Redeemable Convertible Series F Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	3,011,559	⁽¹⁾	I	See footnotes⁽⁴⁾⁽⁵⁾
Option (Right to Buy)	⁽²⁾	07/25/2023	Common Stock	40,000	2.14	D
Option (Right to Buy)	⁽³⁾	03/10/2025	Common Stock	10,000	13.43	D

Explanation of Responses:

1. These shares of redeemable convertible preferred stock are 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 upon the closing of the Issuer's initial public offering. These shares of redeemable convertible preferred stock have no expiration date.

2. All shares underlying this option have vested.

3. 7,708 of the shares underlying this option have vested. The remaining 2,292 shares will vest in 11 monthly installments beginning on May 10, 2018, subject to Mr. Salem's continued service through each vesting date.

4. Represents shares of redeemable convertible preferred stock held directly by BCIP Venture Associates, BCIP Venture Associates-B, BCIP Venture Associates II, LP, BCIP Venture Associates II-B, LP, Bain Capital Venture Fund 2012, L.P., Bain Capital Venture Fund 2014, L.P. and Bain Capital Venture Coinvestment Fund, L.P. (collectively, the "Bain Venture Entities).

5. The governance, investment strategy and decision-making process with respect to the investments held by the Bain Venture Entities is directed by the Executive Committee of Bain Capital Venture Investors, LLC ("BCVI"). Mr. Salem is a Managing Director of BCVI. By virtue of the relationships described in this footnote, Mr. Salem may be deemed to share voting and dispositive power with respect to all of the shares of redeemable convertible preferred stock held by the Bain Venture Entities. Mr. Salem disclaims beneficial ownership except to the extent of his pecuniary interest therein.

6. Represents shares of redeemable convertible preferred stock held directly by NPI Capital, LLC. Mr. Salem is the managing member of NPI Capital, LLC.

Remarks:

	/s/ Enrique T. Salem	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).
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.

Enrique T Salem Form 3DOCUSIGN / Enrique T Salem ownership change