0000899243-21-044350.txt : 20211112 0000899243-21-044350.hdr.sgml : 20211112 20211112161147 ACCESSION NUMBER: 0000899243-21-044350 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211110 FILED AS OF DATE: 20211112 DATE AS OF CHANGE: 20211112 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: AMAZON COM INC CENTRAL INDEX KEY: 0001018724 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-CATALOG & MAIL-ORDER HOUSES [5961] STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41042 FILM NUMBER: 211403588 BUSINESS ADDRESS: STREET 1: 410 TERRY AVENUE NORTH CITY: SEATTLE STATE: WA ZIP: 98109 BUSINESS PHONE: 2062661000 MAIL ADDRESS: STREET 1: 410 TERRY AVENUE NORTH CITY: SEATTLE STATE: WA ZIP: 98109 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 2021-11-10 0 0001874178 Rivian Automotive, Inc. / DE RIVN 0001018724 AMAZON COM INC 410 TERRY AVENUE NORTH SEATTLE WA 98109 1 0 1 0 Class A Common Stock 2021-11-10 4 C 0 86186650 A 86186650 I See footnote Class A Common Stock 2021-11-10 4 C 0 30714819 A 116901469 I See footnote Class A Common Stock 2021-11-10 4 C 0 27437057 A 144338526 I See footnote Class A Common Stock 2021-11-10 4 C 0 4070557 A 148409083 I See footnote Class A Common Stock 2021-11-10 4 C 0 7390649 A 155799732 I See footnote Class A Common Stock 2021-11-10 4 A 0 2564102 78.00 A 158363834 I See footnote Series A Preferred Stock 2021-11-10 4 C 0 86186650 0.00 D Class A Common Stock 86186650 0 I See footnote Series D Preferred Stock 2021-11-10 4 C 0 30714819 0.00 D Class A Common Stock 30714819 0 I See footnote Series E Preferred Stock 2021-11-10 4 C 0 27437057 0.00 D Class A Common Stock 27437057 0 I See footnote Series F Preferred Stock 2021-11-10 4 C 0 4070577 0.00 D Class A Common Stock 4070577 0 I See footnote Warrant (Right to Purchase) 9.089 2021-11-10 4 C 0 3723050 D 2029-09-16 Series C Preferred Stock 3723050 0 I See footnote Warrant (Right to Purchase) 9.089 2021-11-10 4 C 0 3723050 A 2021-11-10 2029-09-16 Class A Common Stock 3723050 3723050 I See footnote Convertible Notes 66.30 2021-11-10 4 C 0 490000000.00 0.00 D 2026-07-23 Class A Common Stock 7390649 0 I See footnote Amazon.com NV Investment Holdings LLC, a wholly-owned subsidiary of Amazon.com, Inc. ("Amazon"), is the record holder of the securities listed in this Form 4. Upon the closing of the Issuer's initial public offering, each share of Series A Preferred Stock, Series D Preferred Stock, Series E Preferred Stock and Series F Preferred Stock (collectively, the "Preferred Stock") automatically converted into one share of the Issuer's Class A common stock, par value $0.001 per share (the "Class A Common Stock"). The shares of Preferred Stock had no expiration date. Upon the closing of the Issuer's initial public offering, the warrant to purchase Series C Preferred Stock automatically converted into a warrant to purchase an equivalent number of Class A Common Stock at the same exercise price. Upon the closing of the Issuer's initial public offering, the Convertible Notes automatically converted into shares of Class A Common Stock at a conversion price equal to the lesser of: (i) $71.03 and (ii) the product of (x) the initial public offering price per share of $78.00 multiplied by (y) the applicable discount rate determined by reference to the time of conversion (0.85). /s/ David A. Zapolsky, Senior Vice President 2021-11-12