0000899243-16-013233.txt : 20160212
0000899243-16-013233.hdr.sgml : 20160212
20160212170022
ACCESSION NUMBER: 0000899243-16-013233
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20151231
FILED AS OF DATE: 20160212
DATE AS OF CHANGE: 20160212
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Facebook Inc
CENTRAL INDEX KEY: 0001326801
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370]
IRS NUMBER: 201665019
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1601 WILLOW ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-618-7714
MAIL ADDRESS:
STREET 1: 1601 WILLOW ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Zuckerberg Mark
CENTRAL INDEX KEY: 0001548760
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35551
FILM NUMBER: 161420431
MAIL ADDRESS:
STREET 1: C/O FACEBOOK, INC.
STREET 2: 1601 WILLOW ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
5
1
doc5.xml
FORM 5 SUBMISSION
X0306
5
2015-12-31
0
0
0
0001326801
Facebook Inc
FB
0001548760
Zuckerberg Mark
C/O FACEBOOK, INC.
1601 WILLOW ROAD
MENLO PARK
CA
94025
1
1
1
0
COB and CEO
Class A Common Stock
2015-05-11
5
G
0
282883
0.00
D
1050117
I
By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 1 Dated 5/8/2014
Class A Common Stock
2015-05-11
5
G
0
282883
0.00
A
283124
I
By Mark Zuckerberg, Trustee Of The Mark Zuckerberg Trust Dated July 7, 2006
Class A Common Stock
2015-05-11
5
G
0
108413
0.00
D
1224587
I
By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT
No. 2 Dated 5/8/2014
Class A Common Stock
2015-05-11
5
G
0
108413
0.00
A
391537
I
By Mark Zuckerberg, Trustee Of The Mark Zuckerberg Trust Dated
July 7, 2006
Class A Common Stock
2015-05-11
5
G
0
54409
0.00
D
1278591
I
By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT
No. 3 Dated 5/8/2014
Class A Common Stock
2015-05-11
5
G
0
54409
0.00
A
445946
I
By Mark Zuckerberg, Trustee Of The Mark Zuckerberg Trust Dated
July 7, 2006
Class A Common Stock
2015-12-22
5
J
0
160
0.00
D
445786
I
By Mark Zuckerberg, Trustee Of The Mark Zuckerberg Trust Dated
July 7, 2006
Class A Common Stock
2015-12-22
5
J
0
160
0.00
A
160
I
By Chan Zuckerberg Initiative, LLC
Class A Common Stock
2015-12-22
5
J
0
282883
0.00
D
162903
I
By Mark Zuckerberg,
Trustee Of The Mark
Zuckerberg Trust Dated July 7, 2006
Class A Common Stock
2015-12-22
5
J
0
282883
0.00
A
283043
I
By Chan Zuckerberg Initiative, LLC
Class A Common Stock
2015-12-22
5
J
0
54409
0.00
D
108494
I
By Mark Zuckerberg, Trustee Of The Mark Zuckerberg Trust Dated
July 7, 2006
Class A Common Stock
2015-12-22
5
J
0
54409
0.00
A
337452
I
By Chan Zuckerberg Initiative, LLC
Class A Common Stock
2015-12-22
5
J
0
108413
0.00
D
81
I
By Mark Zuckerberg, Trustee Of The Mark Zuckerberg Trust Dated
July 7, 2006
Class A Common Stock
2015-12-22
5
J
0
108413
0.00
A
445865
I
By Chan Zuckerberg Initiative, LLC
Class A Common Stock
2015-12-22
5
J
0
81
0.00
D
0
I
By Mark Zuckerberg, Trustee Of The Mark Zuckerberg Trust Dated
July 7, 2006
Class A Common Stock
2015-12-22
5
J
0
81
0.00
A
445946
I
By Chan Zuckerberg Initiative, LLC
Class B Common Stock
2015-05-11
5
G
0
25986
0.00
D
Class A Common Stock
25986
3271779
I
By Mark Zuckerberg,
Trustee Of The Mark
Zuckerberg 2008
Annuity Trust Dated
March 13, 2008
Class B Common Stock
2015-05-11
5
G
0
25986
0.00
A
Class A Common Stock
25986
373897306
I
By Mark Zuckerberg,
Trustee Of The Mark
Zuckerberg Trust Dated
July 7, 2006
Class B Common Stock
2015-05-11
5
G
0
3271779
0.00
D
Class A Common Stock
3271779
0
I
By Mark Zuckerberg,
Trustee Of The Mark
Zuckerberg 2008
Annuity Trust Dated
March 13, 2008
Class B Common Stock
2015-12-01
5
G
0
45083762
0.00
D
Class A Common Stock
45083762
0
D
Class B Common Stock
2015-12-01
5
G
0
45083762
0.00
A
Class A Common Stock
45083762
418981068
I
By Mark Zuckerberg,
Trustee Of The Mark
Zuckerberg Trust Dated
July 7, 2006
Class B Common Stock
2015-12-22
5
J
0
414123745
0.00
D
Class A Common Stock
414123745
4857323
I
By Mark Zuckerberg,
Trustee Of The Mark
Zuckerberg Trust Dated
July 7, 2006
Class B Common Stock
2015-12-22
5
J
0
414123745
0.00
A
Class A Common Stock
414123745
414123745
I
By Chan Zuckerberg
Initiative, LLC
Class B Common Stock
Class A Common Stock
3
3
I
By Mark Zuckerberg,
Trustee Of The
Openness Trust Dated
April 2, 2012
Shares held of record by Mark Zuckerberg, Trustee of The Mark Zuckerberg 2014 GRAT No. 1, dated 5/8/2014.
Shares held of record by Mark Zuckerberg, Trustee of The Mark Zuckerberg Trust dated July 7, 2006 (2006 Trust).
Shares held of record by Mark Zuckerberg, Trustee of The Mark Zuckerberg 2014 GRAT No. 2, dated 5/8/2014.
Shares held of record by Mark Zuckerberg, Trustee of The Mark Zuckerberg 2014 GRAT No. 3, dated 5/8/2014.
Shares contributed from the 2006 Trust to Chan Zuckerberg Initiative, LLC (CZI). The 2006 Trust is the sole member of CZI.
The 2006 Trust is the sole member of CZI. Mr. Zuckerberg is the sole trustee of the 2006 Trust and, therefore, is deemed to have sole voting and investment power over the securities held by CZI.
The Class B Common Stock is convertible into the issuer's Class A Common Stock on a 1-for-1 basis (a) at the holder's option or (b) upon certain transfers of such shares and has no expiration date.
Shares held of record by Mark Zuckerberg, Trustee of The Mark Zuckerberg 2008 Annuity Trust dated March 13, 2008.
This transaction represents a transfer of shares that were beneficially owned by the reporting person for the purposes of estate planning and not a sale of securities.
Shares held of record by Mark Zuckerberg, Trustee of the Openness Trust dated April 2, 2012.
/s/ Michael Johnson as attorney-in-fact for Mark Zuckerberg
2016-02-12