-----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, UtVxNNIJMm11VlkDiN6P8JqiRbrZFRQ9T90bora3XLYtO0S82M4iIFLC3NQeZ15j Px9e1Xp0CSeT0Ofy+LVHNg== 0001181431-10-034764.txt : 20100625 0001181431-10-034764.hdr.sgml : 20100625 20100625155745 ACCESSION NUMBER: 0001181431-10-034764 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: Musk Kimbal CENTRAL INDEX KEY: 0001494731 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34756 FILM NUMBER: 10917657 MAIL ADDRESS: STREET 1: C/O TESLA MOTORS, INC. STREET 2: 3500 DEER CREEK ROAD CITY: PALO ALTO STATE: CA ZIP: 94304 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 rrd279897.xml FORM 3 X0203 3 2010-06-28 0 0001318605 TESLA MOTORS INC TSLA 0001494731 Musk Kimbal ONE MERCEDES DR. MONTVALE NJ 07645 1 0 0 0 Common Stock 33333 I See Footnote Series B Preferred Stock Common Stock 540540 I See Footnote Series E Preferred Stock Common Stock 594857 I See Footnote Option to Buy (Common Stock) 6.63 2011-03-03 2017-03-02 Common Stock 16666 I See Footnote The shares are directly held by Jasper Holdings LLC which is owned by the reporting person and his spouse. Each share of the Issuer's Series B preferred stock and Series E preferred stock will automatically convert into .333333 of a share of common stock upon the closing the Issuer's initial public offering, and has no expiration date. 100% of the shares subject to the option will become vested and exercisable on March 3, 2011. The anticipated effective date of the Issuer's initial public offering is June 28, 2010. /s/ Kimbal Musk 2010-06-25 -----END PRIVACY-ENHANCED MESSAGE-----