-----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, U40WfzTG3iyUwOl9QScFMSbFifeymXZo1ylippE+jV/dThvE+64x8DMkLlyAdWBF 4pBh7/h1MPzgDuIjjqriFw== 0001140361-10-027087.txt : 20100625 0001140361-10-027087.hdr.sgml : 20100625 20100625171653 ACCESSION NUMBER: 0001140361-10-027087 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100628 FILED AS OF DATE: 20100625 DATE AS OF CHANGE: 20100625 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kohler Herbert CENTRAL INDEX KEY: 0001495013 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34756 FILM NUMBER: 10918281 MAIL ADDRESS: STREET 1: MERCEDESSTRASSE 137 CITY: STUTTGART STATE: 2M ZIP: 70327 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 3 1 doc1.xml FORM 3 X0203 3 2010-06-28 0 0001318605 TESLA MOTORS INC TSLA 0001495013 Kohler Herbert MERCEDESSTRASSE 137 STUTTGART 2M 70327 GERMANY 1 0 0 0 Series E Preferred Stock Common Stock 19901290 I See footnote. Series F Preferred Stock Common Stock 2525933 I See footnote. Right to Buy (Common Stock) 6.63 2010-05-11 2016-12-03 Common Stock 33333 I See footnote. Each share of the Issuer's Series E preferred stock and Series F preferred stock will automatically convert into .333333 of a share of common stock upon the closing of the Issuer's initial public offering, and has no expiration date. The shares are owned directly by Blackstar Investco LLC, which is 60% owned by Daimler North America Corporation and 40% owned by Aabar Blackstar Holdings GmbH. The reporting person is a vice president of Blackstar Investco 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. 1/4th of the shares subject to the option became vested and exercisable on May 11, 2010 and 1/48th of the shares subject to the option shall become vested and exercisable each month thereafter. The option is held by Daimler North America Corporation, and the reporting person disclaims beneficial ownership of the shares subject to the option, 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. The anticipated effective date of the Issuer's initial public offering is June 28, 2010. /s/ Herbert Kohler 2010-06-25 -----END PRIVACY-ENHANCED MESSAGE-----