SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
Taneja Vaibhav

(Last) (First) (Middle)
C/O TESLA, INC.
3500 DEER CREEK ROAD

(Street)
PALO ALTO CA 94304

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/13/2019
3. Issuer Name and Ticker or Trading Symbol
Tesla, Inc. [ TSLA ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Accounting Officer
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 951 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Incentive Stock Option (right to buy) (1) 10/16/2028 Common Stock 979 $276.59 D
Incentive Stock Option (right to buy) (2) 11/12/2027 Common Stock 924 $315.4 D
Non-Qualified Stock Option (right to buy) (1) 10/16/2028 Common Stock 572 $276.59 D
Non-Qualified Stock Option (right to buy) (3) 04/25/2026 Common Stock 1,760 $300 D
Restricted Stock Unit (4) (4) Common Stock 770 $0.0 D
Restricted Stock Unit (5) (5) Common Stock 1,403 $0.0 D
Restricted Stock Unit (6) (6) Common Stock 492 $0.0 D
Restricted Stock Unit (7) (7) Common Stock 1,090 $0.0 D
Restricted Stock Unit (8) (8) Common Stock 550 $0.0 D
Explanation of Responses:
1. 1/60th of the shares subject to the option became vested and exercisable on November 1, 2018, and 1/60th of the shares subject to the option shall become vested and exercisable each month thereafter, so that all such shares subject to this option will be fully vested by October 1, 2023.
2. 1/48th of the shares subject to the option vested on October 5, 2017 and 1/48th of the shares subject to the option will vest each monthly anniversary of the grant date, so that all such shares subject to this option will be fully vested as of September 5, 2021.
3. 1/4th of the shares subject to the option became vested and exercisable on April 15, 2017 and 1/48th of the shares subject to the option shall vest and become exercisable each month thereafter, so that all such shares subject to this option will be fully vested as of April 15, 2020.
4. 1/16th of the total restricted stock units initially subject to this award vested on December 5, 2017, and 1/16th of the total units initially subject to this award vest every three months thereafter, so that all such shares subject to this award will be fully vested as of September 5, 2021.
5. 1/16th of the total restricted stock units initially subject to this award vested on September 5, 2018, and 1/16th of the total units initially subject to this award vest every three months thereafter, so that all such shares subject to this award will be fully vested as of June 5, 2022.
6. 1/20th of the total restricted stock units initially subject to this award vested on March 5, 2019 and 1/20th of the total units initially subject to this award vest every three months thereafter, so that all such shares subject to this award will be fully vested by December 5, 2023.
7. 1/16th of the total restricted stock units initially subject to this award vested on March 5, 2019 and 1/16th of the total units initially subject to this award vest every three months thereafter, so that all such shares subject to this award will be fully vested as of December 5, 2022.
8. 1/4th of the total restricted stock units initially subject to this award vested on May 15, 2017, and 1/16th of the total units initially subject to this award vest every three months thereafter, so that all such shares subject to this award will be fully vested as of May 15, 2020.
By: Aaron Beckman, Power of Attorney For: Vaibhav Taneja 03/25/2019
** 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 5 (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.