-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, IsOhTQtl0Z5VvOgDbN6OhbYLT0KqCem0VqHXM3Ug8HBluX2cDWnpfHBFAT5Ghksg jbXUVVjB5Tpeygu/YL31yg== 0001181431-10-035860.txt : 20100702 0001181431-10-035860.hdr.sgml : 20100702 20100702143503 ACCESSION NUMBER: 0001181431-10-035860 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100702 FILED AS OF DATE: 20100702 DATE AS OF CHANGE: 20100702 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jurvetson Stephen T CENTRAL INDEX KEY: 0001314917 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34756 FILM NUMBER: 10935557 MAIL ADDRESS: STREET 1: 2882 SAND HILL ROAD, SUITE 150 CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TESLA MOTORS INC CENTRAL INDEX KEY: 0001318605 STANDARD INDUSTRIAL CLASSIFICATION: MOTOR VEHICLES & PASSENGER CAR BODIES [3711] IRS NUMBER: 912197729 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 1050 BING STREET CITY: SAN CARLOS STATE: CA ZIP: 94070 BUSINESS PHONE: 650-413-6222 MAIL ADDRESS: STREET 1: 1050 BING STREET CITY: SAN CARLOS STATE: CA ZIP: 94070 4 1 rrd280657.xml FORM 4 X0303 4 2010-07-02 0 0001318605 TESLA MOTORS INC TSLA 0001314917 Jurvetson Stephen T 2882 SAND HILL ROAD, SUITE 150 MENLO PARK CA 94025 1 0 0 0 Common Stock 2010-07-02 2010-07-02 4 C 0 154151 A 154151 I See Footnotes Common Stock 2010-07-02 2010-07-02 4 C 0 775292 A 775292 I See Footnotes Common Stock 2010-07-02 2010-07-02 4 C 0 62680 A 62680 I See Footnotes Common Stock 2010-07-02 2010-07-02 4 C 0 38537 A 38537 I See Footnotes Common Stock 2010-07-02 2010-07-02 4 C 0 1734208 A 1734208 I See Footnotes Series C Preferred Stock 2010-07-02 2010-07-02 4 C 0 2233480 0.00 D Common Stock 781745 0 I See Footnotes Series D Preferred Stock 2010-07-02 2010-07-02 4 C 0 473918 0.00 D Common Stock 157972 0 I See Footnotes Series E Preferred Stock 2010-07-02 2010-07-02 4 C 0 5475457 0.00 D Common Stock 1825151 0 I See Footnotes Each share of the Issuer's Series C preferred stock automatically converted into .350013 of a share of common stock upon the closing the Issuer's initial public offering, and has no expiration date. Each share of the Issuer's Series E preferred stock and Series D Preferred Stock automatically converted to .333333 of a share common stock upon the closing of the Issuer's initial public offering and has no expiration date. These shares are owned directly by Draper Associates, L.P. These shares are owned directly by Draper Fisher Jurvetson Growth Fund 2006, L.P. These shares are owned directly by Draper Fisher Jurvetson Growth Fund 2006, LLC These shares are owned directly by Draper Fisher Jurvetson Partners VIII, LLC These shares are owned directly by Draper Fisher Jurvetson Fund VIII, L.P. 62,539 of these shares are owned directly by Draper Associates, L.P., 15,635 shares are owned directly by Draper Fisher Jurvetson Partners VIII, LLC and 703,571 shares are owned directly by Draper Fisher Jurvetson Fund VIII, L.P. 12,638 shares are owned directly by Draper Associates, L.P., 3,159 shares are owned directly by Draper Fisher Jurvetson Partners VIII, LLC and 142,175 shares are owned directly by Draper Fisher Jurvetson Fund VIII, L.P. 78,974 shares are owned directly by Draper Associates, L.P., 775,292 shares are owned directly by Draper Fisher Jurvetson Partners Growth Fund 2006, L.P., 62,680 shares are owned directly by Draper Fisher Jurvetson Partners Growth Fund 2006, LLC, 19,743 shares are owned directly by Draper Fisher Jurvetson Partners VIII, LLC and 888,462 shares are owned directly by Draper Fisher Jurvetson Fund VIII, L.P. The reporting person is a managing director of the general partner of the Draper Fisher Jurvetson Fund VIII, L.P., a managing member of Draper Fisher Jurveston Partners VIII, LLC and a managing member of the general partner of the Draper Fisher Jurvetson Partners Growth Fund 2006, LLC, and disclaims beneficial ownership of these shares, except to the extent of his pecuniary interest therein. This report shall not be deemed an admission that the reporting person is the beneficiary owner of such securities for Section 16 or any other purpose. /s/ Stephen T. Jurvetson 2010-07-02 -----END PRIVACY-ENHANCED MESSAGE-----