0001584518-21-000001.txt : 20210114 0001584518-21-000001.hdr.sgml : 20210114 20210114181438 ACCESSION NUMBER: 0001584518-21-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210111 FILED AS OF DATE: 20210114 DATE AS OF CHANGE: 20210114 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Guillen Jerome M CENTRAL INDEX KEY: 0001584518 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34756 FILM NUMBER: 21530009 MAIL ADDRESS: STREET 1: 3500 DEER CREEK RD. CITY: PALO ALTO STATE: CA ZIP: 94304 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Tesla, Inc. CENTRAL INDEX KEY: 0001318605 STANDARD INDUSTRIAL CLASSIFICATION: MOTOR VEHICLES & PASSENGER CAR BODIES [3711] IRS NUMBER: 912197729 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3500 DEER CREEK RD CITY: PALO ALTO STATE: CA ZIP: 94304 BUSINESS PHONE: 650-681-5000 MAIL ADDRESS: STREET 1: 3500 DEER CREEK RD CITY: PALO ALTO STATE: CA ZIP: 94304 FORMER COMPANY: FORMER CONFORMED NAME: TESLA MOTORS INC DATE OF NAME CHANGE: 20050222 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2021-01-11 0 0001318605 Tesla, Inc. TSLA 0001584518 Guillen Jerome M 3500 DEER CREEK RD. PALO ALTO CA 94304 0 1 0 0 President, Automative Common Stock 2021-01-11 4 M 0 10000 55.32 A 59959 D Non-Qualified Stock Option (right to buy) 55.32 2021-01-11 4 M 0 10000 0 D 2028-10-16 Common Stock 10000 496975 D The transactions reported on this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on October 26, 2020. 6/60th of the shares subject to the option became vested and exercisable on April 1, 2019, and 1/60th of the shares subject to the option shall become vested and exercisable each month thereafter, so that all such shares subject to this option shall be fully vested as of October 1, 2023. This Form 4 is the first of two Form 4s being filed by the Reporting Person relating to the same event. The Form 4 has been split into two filings to cover all 31 individual transactions that occurred on the same Transaction Date, because the SEC's EDGAR filing system limits a single Form 4 to a maximum of 30 separate transactions. Each Form 4 will be filed by the Reporting Person. By: Aaron Beckman, Power of Attorney For: Jerome M. Guillen 2021-01-14