SEC FORM 3

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

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1. Name and Address of Reporting Person^*

Bullock D Fraser

(Last)

(First)

(Middle)

C/O DOMO, INC.

772 EAST UTAH VALLEY DRIVE

(Street)

AMERICAN FORK

84003

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
06/28/2018

3. Issuer Name and Ticker or Trading Symbol
DOMO, INC. [ DOMO ]

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)
Class B Common Stock	8,666	I	See footnote⁽¹⁾
Class B Common Stock	8,789	I	See footnote⁽²⁾
Class B Common Stock	20,000⁽³⁾	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)
Series A Preferred Stock	⁽⁴⁾	⁽⁴⁾	Class B Common Stock	18,783	⁽⁴⁾	I	See footnote⁽²⁾
Series C Preferred Stock	⁽⁴⁾	⁽⁴⁾	Class B Common Stock	70,190	⁽⁴⁾	I	See footnote⁽²⁾

Explanation of Responses:

1. The reported securities are held directly by the Bullock Family 2003 Gift Trust. Jennifer Bullock serves as trustee to the Bullock Family 2003 Gift Trust. The Reporting Person disclaims beneficial ownership of the securities held by the Bullock Family 2003 Gift Trust except to the extent of any pecuniary interest therein.

2. The reported securities are held directly by the Bullock Family 101 Trust. Robert Gardner serves as trustee to the Bullock Family 101 Trust. The Reporting Person disclaims beneficial ownership of the securities held by the Bullock Family 101 Trust except to the extent of any pecuniary interest therein.

3. The shares are represented by restricted stock units ("RSUs"). Each RSU represents the Reporting Person's right to receive one share of Class B Common Stock of the Issuer, subject to the applicable vesting schedule. In the event the Reporting Person ceases to be a Service Provider, the unvested RSUs will be cancelled by the Issuer.

4. Each of the Series A Preferred Stock and Series C Preferred Stock shall automatically convert into shares of Class B Common Stock on a one to one basis immediately prior to the completion of the Issuer's initial public offering of Class B Common Stock and has no expiration date.

Remarks:

Exhibit 24 Power of Attorney

	/s/ Daniel Stevenson, attorney-in-fact	06/28/2018
	** 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.