Form 4 for DOCS Doximity, Inc.
Accepted 2021-11-15 00:00:00 ET · period of report 2021-11-12 · accession 0000899243-21-044592 · SEC index · Original document
Summary rows
Aggregated the way they appear in lists: one row per insider, transaction code and security table.
| X | Filed | Traded | Ticker | Insider | Title | Type | Price | Qty | Owned | ΔOwn | Value |
|---|---|---|---|---|---|---|---|---|---|---|---|
| DI | 2021-11-15 | 2021-11-12 | DOCS | Kliman Gilbert H | Dir, 10% | C - Cnv Deriv | — | +4.30M | 4.30M | New | — |
| DMI | 2021-11-15 | 2021-11-12 | DOCS | Kliman Gilbert H | Dir, 10% | J - Other | $0.00 | -4.30M | 1.09M | -80% | $0 |
| D | 2021-11-15 | 2021-11-12 | DOCS | Kliman Gilbert H | Dir, 10% | J - Other | $0.00 | +247.1K | 247.1K | New | $0 |
| DI | 2021-11-15 | 2021-11-12 | DOCS | Kliman Gilbert H | Dir, 10% | C - Cnv Deriv | $0.00 | -4.30M | 12.86M | -25% | $0 |
Purchase Sale Sale after option exercise All abbreviations
Every reported transaction
| # | Table | Security | Date | Code | A/D | Shares | Price | Owned after | Own | Exercise / expiry | Underlying | Footnotes |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Common | Class A Common Stock | 2021-11-12 | C | A | 4,300,000 | — | 4,300,000 | I By InterWest Partners X, L.P. | — | — | (F1) 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. (F4) These shares are directly held by IW10. IMP10, as the general partner of IW10, may be deemed to beneficially own the shares held by IW10. The Reporting Person is the Managing Director of IMP10, and as such may be deemed to beneficially own the shares held by IW10. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. |
| 2 | Common | Class A Common Stock | 2021-11-12 | J | D | 1,089,179 | $0.00 | 0 | I By: InterWest Management Partners X, LLC | — | — | (F4) These shares are directly held by IW10. IMP10, as the general partner of IW10, may be deemed to beneficially own the shares held by IW10. The Reporting Person is the Managing Director of IMP10, and as such may be deemed to beneficially own the shares held by IW10. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. |
| 3 | Common | Class A Common Stock | 2021-11-12 | J | A | 247,074 | $0.00 | 247,074 | D | — | — | |
| 4 | Common | Class A Common Stock | 2021-11-12 | J | D | 4,300,000 | $0.00 | 0 | I By InterWest Partners X, L.P. | — | — | (F4) These shares are directly held by IW10. IMP10, as the general partner of IW10, may be deemed to beneficially own the shares held by IW10. The Reporting Person is the Managing Director of IMP10, and as such may be deemed to beneficially own the shares held by IW10. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. |
| 5 | Common | Class A Common Stock | 2021-11-12 | J | A | 1,089,179 | $0.00 | 1,089,179 | I By: InterWest Management Partners X, LLC | — | — | (F4) These shares are directly held by IW10. IMP10, as the general partner of IW10, may be deemed to beneficially own the shares held by IW10. The Reporting Person is the Managing Director of IMP10, and as such may be deemed to beneficially own the shares held by IW10. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. |
| 6 | Derivative | Class B Common Stock | 2021-11-12 | C | D | 4,300,000 | $0.00 | 12,856,998 | I By InterWest Partners X, L.P. | — · — to — | 4,300,000 Class A Common Stock | (F4) These shares are directly held by IW10. IMP10, as the general partner of IW10, may be deemed to beneficially own the shares held by IW10. The Reporting Person is the Managing Director of IMP10, and as such may be deemed to beneficially own the shares held by IW10. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. (F5) Each share of Class B Common Stock is convertible into one share of Class A Common Stock at any time at the option of the holder. Each share of Class B Common Stock held by the 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 the 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. |