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