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 |
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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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
TESLA MOTORS INC [ TSLA ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 05/13/2013 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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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 | 05/13/2013 | 05/13/2013 | J(1)(2) | 200,000 | D | $0 | 16,776 | I | Draper Fisher Jurvetson Fund VIII, L.P.(3) | |
Common Stock | 05/13/2013 | 05/13/2013 | J(1)(2) | 4,444 | D | $0 | 373 | I | Draper Fisher Jurvetson Partners VIII, LLC(4) | |
Common Stock | 05/13/2013 | 05/13/2013 | J(1)(2) | 2,000 | A | $0 | 2,000 | I | Draper Fisher Jurvetson Partners VIII, L.P.(5) | |
Common Stock | 05/13/2013 | 05/13/2013 | J(1)(2) | 1,155 | A | $0 | 43,114 | I | Jurveston Living Trust(6) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 |
Explanation of Responses: |
1. On May 13, 2013, Draper Fisher Jurvetson Fund VIII, L.P. ("Fund VIII") made an in-kind distribution, without any additional consideration, of 200,000 shares of common stock of Tesla Motors Inc. This total included 2,000 shares distributed to the general partner of Fund VIII, Draper Fisher Jurvetson Fund VIII Partners, L.P. ("Fund GP"). Mr. Jurvetson is a Managing Director of the Fund GP. |
2. On May 13, 2013, Draper Fisher Jurvetson Partners VIII, LLC ("Partner Fund"), made an in-kind distribution of 4,444 shares of common stock of Tesla Motors Inc., without any additional consideration, to its members, including Mr. Jurvetson. Mr. Jurvetson received 1,155 shares from this distribution. |
3. These shares are owned directly by Draper Fisher Jurvetson Fund VIII, L.P. |
4. These shares are owned directly by Draper Fisher Jurvetson Partners VIII, LLC. |
5. These shares are owned directly by Draper Fisher Jurvetson Partners VIII, L.P. |
6. These shares are held directly by the Steve and Karla Jurvetson Living Trust dated August 27, 2002 and were acquired in connection with the distribution by Partner Fund. |
Stephen T. Jurvetson | 05/15/2013 | |
** 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. |