0001209191-12-055744.txt : 20121204 0001209191-12-055744.hdr.sgml : 20121204 20121204170412 ACCESSION NUMBER: 0001209191-12-055744 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121201 FILED AS OF DATE: 20121204 DATE AS OF CHANGE: 20121204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Zuckerberg Mark CENTRAL INDEX KEY: 0001548760 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35551 FILM NUMBER: 121241336 MAIL ADDRESS: STREET 1: C/O FACEBOOK, INC. STREET 2: 1601 WILLOW ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Facebook Inc CENTRAL INDEX KEY: 0001326801 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370] IRS NUMBER: 201665019 BUSINESS ADDRESS: STREET 1: 1601 WILLOW ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-618-7714 MAIL ADDRESS: STREET 1: 1601 WILLOW ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2012-12-01 0 0001326801 Facebook Inc FB 0001548760 Zuckerberg Mark C/O FACEBOOK, INC. 1601 WILLOW ROAD MENLO PARK CA 94025 1 1 1 0 COB and CEO Class A Common Stock 2012-12-01 4 J 0 21 0.00 A 68 I By Mark Zuckerberg, Trustee of The Mark Zuckerberg Trust dated July 7, 2006 The shares reported on this Form 4 represent a pro rata distribution, and not a purchase or sale, of the shares by Benchmark Founders' Fund VI, L.P. to its partners without consideration. Shares held of record by Mark Zuckerberg, Trustee of The Mark Zuckerberg Trust dated July 7, 2006. /s/ Michael Johnson as attorney-in-fact for Mark Zuckerberg 2012-12-04