SEC Form 4 · accession 0001670512-16-000008
Tesla, Inc. · TSLA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Stephen T Jurvetson
Director
Period of report
Dec 5, 2016
Accepted (ET)
Dec 7, 2016 · 9:18 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 StockF2 | Dec 5, 2016 | J | 60,645 | $0.00 | D | 121,289 | I | By DFJ GF 06 LP |
| Common StockF4 | Dec 5, 2016 | J | 14,449 | $0.00 | A | 14,505 | I | by DFJ Fd IX Part LP |
| Common StockF4 | Dec 5, 2016 | J | 14,449 | $0.00 | D | 56 | I | by DFJ Fd IX Part LP |
| Common StockF5 | Dec 5, 2016 | J | 90,941 | $0.00 | D | 0 | I | by DFJ Fund IX, LP |
| Common StockF6 | Dec 5, 2016 | J | 2,463 | $0.00 | D | 0 | I | by DFJ Part IX LLC |
| Common StockF7 | Dec 5, 2016 | J | 6,361 | $0.00 | A | 6,361 | I | by DFJGF 06 Prt LP |
| Common StockF7 | Dec 5, 2016 | J | 6,361 | $0.00 | D | 0 | I | by DFJGF 06 Prt LP |
| Common StockF8 | Dec 5, 2016 | J | 4,992 | $0.00 | D | 9,983 | I | by DFJP GF 2006, LLC |
| Common StockF9 | Dec 5, 2016 | J | 471 | $0.00 | A | 97,544 | I | by Trust |
| Common StockF9 | Dec 5, 2016 | J | 2,505 | $0.00 | A | 100,049 | I | by Trust |
| Common StockF9 | Dec 5, 2016 | J | 545 | $0.00 | A | 100,594 | I | by Trust |
| Common StockF9 | Dec 5, 2016 | J | 480 | $0.00 | A | 101,074 | I | by Trust |
| Common StockF10 | holding | — | — | — | 35 | I | by DFJ Fd X Part LP | |
| Common StockF11 | holding | — | — | — | 28,692 | I | by DFJ Fund X, L.P. | |
| Common StockF12 | holding | — | — | — | 876 | I | by DFJP X, LLC |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1On December 5, 2016, 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. 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.
- F10These 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.
- F11These 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.
- F12These 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.
- F2These shares are owned directly by Draper Fisher Jurvetson Growth Funds 2006, L.P.
- F3On December 5, 2016, 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 IX Partners, L.P.
- F5These shares are owned directly by Draper Fisher Jurvetson Fund IX, L.P.
- F6These shares are owned directly by Draper Fisher Jurvetson Partners IX, LLC
- F7These shares are owned directly by Draper Fisher Jurvetson Growth Fund 2006 Partners, L.P.
- F8These shares are owned directly by Draper Fisher Jurvetson Partners Growth Fund 2006, LLC.
- F9These shares are held directly by the Steve and Karla Jurvetson Living Trust dated August 27, 2002.