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*
Moore Sharelynn Faye

(Last) (First) (Middle)
4353 NORTH FIRST STREET

(Street)
SAN JOSE CA 95134

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/11/2022
3. Issuer Name and Ticker or Trading Symbol
Bloom Energy Corp [ BE ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP, Chief Marketing 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)
Class A Common Stock 37,227 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
Restricted Stock Units (1) (1) Class A Common Stock 84,375 (2) D
Restricted Stock Units (3) (3) Class A Common Stock 19,404 (2) D
Restricted Stock Units (4) (4) Class A Common Stock 49,412 (2) D
Restricted Stock Units (5) (5) Class A Common Stock 50,000 (2) D
Explanation of Responses:
1. Each restricted stock unit ("RSU") represents a contingent right to receive one (1) share of the Class A Common Stock of the Issuer upon settlement.
2. This RSU award shall vest in equal quarterly installments beginning on August 15, 2022 and ending on August 15, 2024, subject to Reporting Person remaining a service provider on each applicable vesting date.
3. This RSU award shall vest in equal quarterly installments beginning on August 15, 2022 and ending on February 15, 2024, subject to Reporting Person remaining a service provider on each applicable vesting date.
4. These RSUs vest as to one-third of the shares on the one-year anniversary of the vesting commencement date, which is January 15, 2022, and 1/12th quarterly thereafter, subject to the Reporting Person remaining a service provider through each applicable vesting date.
5. These RSUs vest in full on the one-year anniversary of the vesting commencement date, which is January 15, 2022, subject to the Reporting Person remaining a service provider through each applicable vesting date.
Remarks:
Exhibit 24.1 - Power of Attorney
/s/ Shawn M. Soderberg, as attorney-in-fact 06/02/2022
** 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.