SEC Form 4 · accession 0001495158-17-000004

Tesla, Inc. · TSLA

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Stephen T Jurvetson

Director

Period of report

Feb 24, 2017

Accepted (ET)

Feb 28, 2017 · 9:48 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001318605

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F2	Feb 24, 2017	J	121,289	$0.00	D	0	I	By DFJ GF 06 LP
Common Stock^F4	Feb 24, 2017	J	287	$0.00	A	322	I	by DFJ Fd X Part LP
Common Stock^F4	Feb 24, 2017	J	279	$0.00	D	43	I	by DFJ Fd X Part LP
Common Stock^F5	Feb 24, 2017	J	28,692	$0.00	D	0	I	by DFJ Fund X, L.P.
Common Stock^F6	Feb 24, 2017	J	23,853	$0.00	A	23,853	I	by DFJGF 06 Prt LP
Common Stock^F6	Feb 24, 2017	J	23,853	$0.00	D	0	I	by DFJGF 06 Prt LP
Common Stock^F7	Feb 24, 2017	J	9,983	$0.00	D	0	I	by DFJP GF 2006, LLC
Common Stock^F8	Feb 24, 2017	J	876	$0.00	D	0	I	by DFJP X, LLC
Common Stock^F9	Feb 24, 2017	J	38	$0.00	A	101,112	I	by Trust
Common Stock^F9	Feb 24, 2017	J	23	$0.00	A	101,135	I	by Trust
Common Stock^F9	Feb 24, 2017	J	1,801	$0.00	A	102,936	I	by Trust
Common Stock^F9	Feb 24, 2017	J	1,089	$0.00	A	104,025	I	by Trust
Common Stock^F9	Feb 24, 2017	J	175	$0.00	A	104,200	I	by Trust

Table II — derivative securities

No Table II lines on this filing.

Explanation of responses

F1On February 24, 2017, each of these funds made an in-kind distribution, without any additional consideration to its members, of that number of shares set forth in column 4, including shares distributed to the general partner of each fund.
F2These shares are owned directly by Draper Fisher Jurvetson Growth Fund 2006, L.P.
F3On February 24, 2017 received the shares set forth in column 4 in connection with the distributions described in footnote 1.
F4These shares are owned directly by Draper Fisher Jurvetson Fund X Partners, L.P. Mr. Jurvetson is one of several managing directors of the general partner entities of these funds that directly hold shares and as such Mr. Jurvetson may be deemed to have voting and investment power with respect to such shares. Mr. Jurvetson disclaims beneficial ownership with respect to such shares except to the extent of his pecuniary interest therein.
F5These shares are owned directly by Draper Fisher Jurvetson Fund X, L.P. Mr. Jurvetson is one of several managing directors of the general partner entities of these funds that directly hold shares and as such Mr. Jurvetson may be deemed to have voting and investment power with respect to such shares. Mr. Jurvetson disclaims beneficial ownership with respect to such shares except tothe extent of his pecuniary interest therein.
F6These shares are owned directly by Draper Fisher Jurvetson Growth Fund 2006 Partners, L.P.
F7These shares are owned directly by Draper Fisher Jurvetson Partners Growth Fund 2006, LLC.
F8These shares are owned directly by Draper Fisher Jurvetson Partners X, LLC. Mr. Jurvetson is one of several managing directors of the general partner entities of these funds that directly hold shares and as such Mr. Jurvetson may be deemed to have voting and investment power with respect to such shares. Mr. Jurvetson disclaims beneficial ownership with respect to such shares except to the extent of his pecuniary interest therein.
F9These shares are owned directly by the Steve and Karla Jurvetson Living Trust dated August 27, 2002.