0001127602-17-025978.txt : 20170817
0001127602-17-025978.hdr.sgml : 20170817
20170817202748
ACCESSION NUMBER: 0001127602-17-025978
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170815
FILED AS OF DATE: 20170817
DATE AS OF CHANGE: 20170817
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Koum Jan
CENTRAL INDEX KEY: 0001621141
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35551
FILM NUMBER: 171039967
MAIL ADDRESS:
STREET 1: C/O FACEBOOK, INC.
STREET 2: 1601 WILLOW ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
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
4
1
form4.xml
PRIMARY DOCUMENT
X0306
4
2017-08-15
0001326801
Facebook Inc
FB
0001621141
Koum Jan
C/O FACEBOOK, INC.
1601 WILLOW ROAD
MENLO PARK
CA
94025
1
Class A Common Stock
2017-08-10
5
J
0
E
1110879
0
D
1126044
I
By Jan Koum and BNY Mellon Trust of Delaware, Co-Trustees of The Jan Koum Trust VI U/A/D 8/5/2015
Class A Common Stock
2017-08-10
5
J
0
E
1110879
0
A
9501833
I
By Jan Koum, Trustee of The Butterfly Trust U/A/D 1/20/2004
Class A Common Stock
2017-08-10
5
J
0
E
1126044
0
A
3451985
I
By BNY Mellon Trust of Delaware, Trustee of The Jan Koum Family Trust II U/A/D 2/4/2015
Class A Common Stock
2017-08-10
5
J
0
E
1126044
0
D
0
I
By Jan Koum and BNY Mellon Trust of Delaware, Co-Trustees of The Jan Koum Trust VI U/A/D 8/5/2015
Class A Common Stock
2017-08-15
4
M
0
1242673
0
A
10744506
I
By Jan Koum, Trustee of The Butterfly Trust U/A/D 1/20/2004
Class A Common Stock
2017-08-15
4
F
0
648427
170.75
D
10096079
I
By Jan Koum, Trustee of The Butterfly Trust U/A/D 1/20/2004
Class A Common Stock
2017-08-16
4
S
0
2259000
170.0535
D
7837079
I
By Jan Koum, Trustee of The Butterfly Trust U/A/D 1/20/2004
Class A Common Stock
2017-08-16
4
S
0
688985
170.5287
D
7148094
I
By Jan Koum, Trustee of The Butterfly Trust U/A/D 1/20/2004
Class A Common Stock
2017-08-16
4
S
0
5507
171.2825
D
7142587
I
By Jan Koum, Trustee of The Butterfly Trust U/A/D 1/20/2004
Class A Common Stock
2060265
I
By Jan Koum and BNY Mellon Trust of Delaware, Co-Trustees of The Jan Koum Trust VII U/A/D 10/20/2015
Class A Common Stock
2103543
I
By Jan Koum and BNY Mellon Trust of Delaware, Co-Trustees of The Jan Koum Trust VIII U/A/D 1/29/2016
Class A Common Stock
1314746
I
By Jan Koum, Trustee of The Jan Koum Family Trust U/A/D 4/29/2014
Class A Common Stock
2242880
I
By Jan Koum and BNY Mellon Trust of Delaware, Co-Trustees of The Jan Koum Trust IX U/A/D 4/13/2016
Restricted Stock Units (RSU) (Class A)
2017-08-15
4
M
0
1242673
0
D
2024-11-16
Class A Common Stock
1242673
10769837
D
Represents a transfer of shares from Jan Koum and BNY Mellon Trust of Delaware, Co-Trustees of The Jan Koum Trust VI U/A/D 8/5/2015 to Jan Koum, Trustee of The Butterfly Trust U/A/D 1/20/2004. The reporting person remains the beneficial owner of all of the shares after the transfer.
Shares held of record by Jan Koum and BNY Mellon Trust of Delaware, Co-Trustees of The Jan Koum Trust VI U/A/D 8/5/2015.
Shares held of record by Jan Koum, Trustee of The Butterfly Trust U/A/D 1/20/2004.
Represents a transfer of shares from Jan Koum & BNY Mellon Trust of Delaware, Co-Trustees of The Jan Koum Trust VI U/A/D 8/5/2015 to BNY Mellon Trust of Delaware TR of The Jan Koum Family Trust II U/A/D 2/4/2015.
Shares held of record by BNY Mellon Trust of Delaware, Trustee of The Jan Koum Family Trust II U/A/D 2/4/2015. The reporting person exercises voting and dispositive powers over these shares, but has no pecuniary interest in these shares.
Represents the number of shares of Class A Common Stock that have been withheld by the issuer to satisfy its income tax withholding and remittance obligations in connection with the net settlement of the Restricted Stock Units ("RSUs") listed in Table II and does not represent a sale by the reporting person.
The sales reported on this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the holder.
The reported price in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $169.26 to $170.2550 per share, inclusive. The holder undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon written request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
The reported price in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $170.26 to $171.25 per share, inclusive. The holder undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon written request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
The reported price in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $171.265 to $171.32 per share, inclusive. The holder undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon written request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
Shares held of record by Jan Koum and BNY Mellon Trust of Delaware, Co-Trustees of The Jan Koum Trust VII U/A/D 10/20/2015.
Shares held of record by Jan Koum and BNY Mellon Trust of Delaware, Co-Trustees of The Jan Koum Trust VIII U/A/D 1/29/2016.
Shares held of record by Jan Koum, Trustee of The Jan Koum Family Trust U/A/D 4/29/2014. The reporting person exercises voting and dispositive powers over these shares, but has no pecuniary interest in these shares.
Shares held of record by Jan Koum and BNY Mellon Trust of Delaware, Co-Trustees of The Jan Koum Trust IX U/A/D 4/13/2016.
Each RSU represents a contingent right to receive 1 share of the issuer's Class A Common Stock upon settlement.
The RSUs vest as to (a) 13/60th of the total shares on November 15, 2015, (b) 1/20th of the total shares each quarter thereafter through November 15, 2017, (c) 2/20th of the total shares on each of February 15, 2018, May 15, 2018 and August 15, 2018 and (d) the final 5/60th of the total shares on November 15, 2018; provided, however, that in the event of the reporting person's termination of employment with the issuer under certain circumstances, all of the reporting person's then unvested RSUs shall vest as of the date of such termination of employment.
/s/ Michael Johnson as attorney-in-fact for Jan Koum
2017-08-17