INTERWEST PARTNERS X LP - 12 Nov 2021 Form 4 Insider Report for Doximity, Inc. (DOCS)

Role
10%+ Owner
Signature
/s/ Karen A. Wilson, Attorney-in Fact for InterWest Partners X, LP
Issuer symbol
DOCS
Transactions as of
12 Nov 2021
Net transactions value
$0
Form type
4
Filing time
15 Nov 2021, 15:37:18 UTC
Previous filing
14 Jul 2021
Next filing
06 Dec 2021

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction DOCS Class A Common Stock Conversion of derivative security +4,300,000 4,300,000 12 Nov 2021 Direct F1, F4
transaction DOCS Class A Common Stock Other $0 -4,300,000 -100% $0.000000* 0 12 Nov 2021 Direct F2
transaction DOCS Class A Common Stock Other $0 +1,089,179 $0.000000 1,089,179 12 Nov 2021 By: InterWest Management Partners X, LLC F2, F4
transaction DOCS Class A Common Stock Other $0 -1,089,179 -100% $0.000000* 0 12 Nov 2021 By: InterWest Management Partners X, LLC F3, F4
transaction DOCS Class A Common Stock Other $0 +40,626 $0.000000 40,626 12 Nov 2021 By: Khaled A. Nasr F3, F4
transaction DOCS Class A Common Stock Other $0 +27,229 $0.000000 27,229 12 Nov 2021 By: Keval Desai F3, F4

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction DOCS Class B Common Stock Conversion of derivative security $0 -4,300,000 -25% $0.000000 12,856,998 12 Nov 2021 Class A Common Stock 4,300,000 Direct F1, F4, F5
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
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.
F2 Represents pro rata in-kind distribution by InterWest Partners X, LP ("IW10") without consideration to its limited and general partners in accordance with the terms of the InterWest Partners X, LP Limited Partnership Agreement. Includes 1,089,179 shares distributed to InterWest Management Partners X, LLC ("IMP10") its general partner.
F3 Represents pro rata in-kind distribution by IMP10 without consideration to its members in accordance with the terms of the InterWest Management Partners X, LLC Operating Agreement. Includes 40,626 shares distributed to Khaled A. Nasr ("Nasr"), 27,229 shares distributed to Keval Desai ("Desai") and 247,074 shares distributed to Gilbert H. Kliman ("Kliman"), as reported on Kliman's separate Form 4 in his own name.
F4 These shares are directly held by IW10. IMP10 is the general partner of IW10. Gilbert H. Kliman is the Managing Director of IMP10. Keval Desai and Khaled Nasr are Venture Members of IMP10. Each of IMP10, Gilbert H. Kliman, Keval Desai and Khaled Nasr may be deemed to beneficially own the shares held by IW10, and each of IMP10, Gilbert H. Kliman, Keval Desai and Khaled Nasr disclaims beneficial ownership of only the shares held by IW10, except to the extent of its or 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.

Remarks:

Gilbert H. Kliman, a Managing Director of IMP10, is also a Director of the Issuer and has filed a separate Form 4 in his own name.