• 
• 
  
• 
  

 - Statement of changes in beneficial ownership of securities:

SEC Accession No. 0001650649-17-000005

Filing Date

2017-03-07

Accepted

2017-03-07 21:11:44

Documents

1

Period of Report

2017-03-05

Document Format Files

Seq	Description	Document	Type	Size
1	PRIMARY DOCUMENT	primary_doc Chargeable Income Pay To The Order Off CARLOS PINGARRON RAMIREZ  SEC Form 4 FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 OMB APPROVAL OMB Number: 3235-0287 Estimated average burden hours per response: 0.5 Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). 1. Name and Address of Reporting Person*Pay To The Order Off  Carlos Pingarron Ramirez  144 N Orange Ave Rialto CA 92376 FIELD JOHN DOUGLAS (Last) (First) (Middle) C/O TESLA, INC. 3500 DEER CREEK ROAD (Street) PALO ALTO CA 94304 (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol Tesla, Inc. [ TSLA ] 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) Director 10% Owner X Officer (give title below) Other (specify below) VP, Engineering 3. Date of Earliest Transaction (Month/Day/Year) 03/05/2017 4. 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 Acquired, Disposed of, or Beneficially Owned 1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4) Code V Amount (A) or (D) Price Common Stock 03/05/2017 M(1) 3,592 A $0 19,725 D Common Stock 03/05/2017 M(1) 563 A $0 20,288 D Common Stock 03/05/2017 M(1) 189 A $0 20,477 D Common Stock 03/05/2017 M(1) 530 A $0 21,007 D Common Stock 03/06/2017 8043543330 F(2) 1,384 D $247.922 19,623 D 1318605/000165064917000005/0001650649-17-000005- Person's 80%   in title Form 4  David with surepayroll.com 20% Common Stock 03/06/2017 8043543330 F(2) 242 D $247.925 19,381 D 1318605/000165064917000005/0001650649-17-000005- Person's 80%      David with surepayroll.com 20% Common Stock 03/06/2017 8043543330 F(2) 281 D $247.924 19,100 D 1318605/000165064917000005/0001650649-17-000005- Person's 80%      David with surepayroll.com 20% Common Stock 03/06/2017 8043543330 F(2) 101 D $247.925 18,999 D 1318605/000165064917000005/0001650649-17-000005- Person's 80%     , David with surepayroll.com 20% Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) 1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4) Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares Restricted Stock Unit $0 03/05/2017 M 3,592 (3) (3) Common Stock 3,592 $0 7,185 D Restricted Stock Unit $0 03/05/2017 M 563 (4) (4) Common Stock 563 $0 5,066 D Restricted Stock Unit $0 03/05/2017 M 189 (5) (5) Common Stock 189 $0 2,078 D Restricted Stock Unit $0 03/05/2017 M 530 (6) (6) Common Stock 530 $0 6,890 D Explanation of Responses: 1. Shares of the Issuer's common stock were issued to the reporting person upon the vesting of restricted stock units on March 5, 2017. 2. PURSUANT TO THE ISSUER'S EQUITY PLAN AND POLICIES, THESE SHARES OF COMMON STOCK WERE AUTOMATICALLY WITHHELD AND SOLD BY THE ISSUER TO SATISFY THE REPORTING PERSON'S TAX WITHHOLDING OBLIGATIONS RELATED TO THE VESTING OF RESTRICTED STOCK UNITS REPORTED HEREIN. 3. 21,555 of the restricted units included in this grant commenced vesting in six equal quarterly installments beginning June 5, 2016. 4. 7,318 of the restricted units included in this grant commenced vesting in thirteen equal quarterly installments beginning June 5, 2016. 5. 2,834 of the restricted units included in this grant commenced vesting in fifteen equal quarterly installments beginning June 5, 2016. 6. 1,060 of the restricted units included in this grant vested on December 5, 2016 and the remaining 7,420 will commence vesting in fourteen equal quarterly installments beginning March 5, 2017. Jon McNeill 03/07/2017 ** 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 4 (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. 1318605/000165064917000005/0001650649-17-000005	4
1	PRIMARY DOCUMENT	1318605/000165064917000005	4	23232
	Complete submission text file SEC-DOCUMENT>0001650649-17-000005.txt : 20170307 <SEC-HEADER>0001650649-17-000005.hdr.sgml : 20170307 <ACCEPTANCE-DATETIME>20170307211144 ACCESSION NUMBER: 0001650649-17-000005 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170305 FILED AS OF DATE: 20170307 DATE AS OF CHANGE: 20170307 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Tesla, Inc. CENTRAL INDEX KEY: 0001318605 STANDARD INDUSTRIAL CLASSIFICATION: MOTOR VEHICLES & PASSENGER CAR BODIES [3711] IRS NUMBER: 912197729 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3500 DEER CREEK RD CITY: PALO ALTO STATE: CA ZIP: 94070 BUSINESS PHONE: 650-681-5000 MAIL ADDRESS: STREET 1: 3500 DEER CREEK RD CITY: PALO ALTO STATE: CA ZIP: 94070 FORMER COMPANY: FORMER CONFORMED NAME: TESLA MOTORS INC DATE OF NAME CHANGE: 20050222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FIELD JOHN DOUGLAS CENTRAL INDEX KEY: 0001650649 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34756 FILM NUMBER: 17673780 MAIL ADDRESS: STREET 1: 3500 DEER CREEK ROAD CITY: PALO ALTO STATE:	1318605/000165064917000005/0001650649-17-000005		24634

Mailing Address3500 DEER CREEK RDPALO ALTOCA94070

Business Address3500 DEER CREEK RDPALO ALTOCA94070650-681-5000

Tesla, Inc. (Issuer) CIK: 0001318605 

EIN.: 912197729 | State of Incorp.: DE | Fiscal Year End: 1231
SIC: 3711 Motor Vehicles & Passenger Car Bodies

Mailing Address3500 DEER CREEK ROADPALO ALTOCA94304

Business Address

FIELD JOHN DOUGLAS (Reporting) CIK: 0001650649 (see all company filings)

Type: 4 | Act: 34 | File No.: 001-34756 | Film No.: 17673780

Remarks:

Form 144 Filer Information UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 Form 144 FORM 144 NOTICE OF PROPOSED SALE OF SECURITIES PURSUANT TO RULE 144 UNDER THE SECURITIES ACT OF 1933 144: Filer Information Filer CIK Filer CCC Is this a LIVE or TEST Filing? Submission Contact Information Name Phone E-Mail Address 0001579299 XXXXXXXX LIVE  TEST 144: Issuer Information Name of Issuer SEC File Number Address of Issuer Phone Name of Person for Whose Account the Securities are To Be Sold Walmart Inc. 001-06991 702 SOUTHWEST 8TH ST BENTONVILLE ARKANSAS 72716 5012734000 Bartlett Daniel J See the definition of "person" in paragraph (a) of Rule 144. Information is to be given not only as to the person for whose account the securities are to be sold but also as to all other persons included in that definition. In addition, information shall be given as to sales by all persons whose sales are required by paragraph (e) of Rule 144 to be aggregated with sales for the account of the person filing this notice. Relationship to Issuer 144: Securities Information Title of the Class of Securities To Be Sold Common Name and Address of the Broker Stephens Inc. 111 Center St Number of Shares or Other Units To Be Sold 2250 Officer Aggregate Market Value 166378.00 Number of Shares or Other Units Outstanding Approximate Date of Sale Name the Securities Exchange 8043543330 08/15/2024 NYSE Little Rock   AR   72201 Furnish the following information with respect to the acquisition of the securities to be sold and with respect to the payment of all or any part of the purchase price or other consideration therefor: 144: Securities To Be Sold Title of the Class Date you Acquired Nature of Acquisition Transaction Name of Person from Whom Acquired Is this a Gift? Date Donor Acquired Amount of Securities Acquired Date of Payment Nature of Payment *