0000899243-21-045166.txt : 20211117
0000899243-21-045166.hdr.sgml : 20211117
20211117194601
ACCESSION NUMBER: 0000899243-21-045166
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211115
FILED AS OF DATE: 20211117
DATE AS OF CHANGE: 20211117
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Boone Karen
CENTRAL INDEX KEY: 0001561290
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41042
FILM NUMBER: 211422178
MAIL ADDRESS:
STREET 1: 15 KOCH ROAD
STREET 2: SUITE J
CITY: CORTE MADERA
STATE: CA
ZIP: 94925
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Rivian Automotive, Inc. / DE
CENTRAL INDEX KEY: 0001874178
STANDARD INDUSTRIAL CLASSIFICATION: MOTOR VEHICLES & PASSENGER CAR BODIES [3711]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 14600 MYFORD ROAD
CITY: IRVINE
STATE: CA
ZIP: 92618
BUSINESS PHONE: (888) 748-4261
MAIL ADDRESS:
STREET 1: 14600 MYFORD ROAD
CITY: IRVINE
STATE: CA
ZIP: 92618
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-11-15
0
0001874178
Rivian Automotive, Inc. / DE
RIVN
0001561290
Boone Karen
C/O RIVIAN AUTOMOTIVE, INC.
14600 MYFORD ROAD
IRVINE
CA
92606
1
0
0
0
Class A Common Stock
2021-11-15
4
P
0
20000
78.00
A
20209
D
Class A Common Stock
65000
I
See footnote
Class A Common Stock
65000
I
See footnote
By The Andrew J. Boone 2021 Grantor Retained Annuity Trust under Irrevocable Trust Agreement dated September 24, 2021.
By The Karen L. Boone 2021 Grantor Retained Annuity Trust under Irrevocable Trust Agreement dated September 24, 2021.
/s/ Neil Sitron, Attorney-in-Fact
2021-11-17