Gilbert H. Kliman - Nov 12, 2021 Form 4 Insider Report for Doximity, Inc. (DOCS)

Role
Director, 10%+ Owner
Signature
/s/ Karen A. Wilson, Attorney-in Fact for Gilbert H. Kliman
Stock symbol
DOCS
Transactions as of
Nov 12, 2021
Transactions value $
$0
Form type
4
Date filed
11/15/2021, 03:38 PM
Previous filing
Sep 10, 2021
Next filing
Dec 6, 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 +4.3M 4.3M Nov 12, 2021 By InterWest Partners X, L.P. F1, F4
transaction DOCS Class A Common Stock Other $0 -4.3M -100% $0.00* 0 Nov 12, 2021 By InterWest Partners X, L.P. F2, F4
transaction DOCS Class A Common Stock Other $0 +1.09M $0.00 1.09M Nov 12, 2021 By: InterWest Management Partners X, LLC F2, F4
transaction DOCS Class A Common Stock Other $0 -1.09M -100% $0.00* 0 Nov 12, 2021 By: InterWest Management Partners X, LLC F3, F4
transaction DOCS Class A Common Stock Other $0 +247K $0.00 247K Nov 12, 2021 Direct F3

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 -4.3M -25.06% $0.00 12.9M Nov 12, 2021 Class A Common Stock 4.3M By InterWest Partners X, L.P. 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 247,074 shares distributed to Gilbert H. Kliman ("Kliman").
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.