Sec Form 4 Filing - Jurvetson Stephen T @ Tesla, Inc. - 2019-11-22

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Jurvetson Stephen T
2. Issuer Name and Ticker or Trading Symbol
Tesla, Inc. [ TSLA]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O TESLA, INC., 3500 DEER CREEK ROAD
3. Date of Earliest Transaction (MM/DD/YY)
11/22/2019
(Street)
PALO ALTO, CA94304
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 11/22/2019 M( 1 ) 13,889 A $ 261.89 13,889 D
Common Stock 11/22/2019 M( 1 ) 3,334 A $ 250.69 17,223 D
Common Stock 11/22/2019 S( 1 ) 17,223 D $ 332.444 ( 2 ) 0 D
Common Stock 43 I by DFJ Fd X Part LP ( 3 )
Common Stock 52,100 I by Trust ( 4 )
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Non-Qualified Stock Option (right to buy) $ 250.69 11/22/2019 M 3,334 ( 5 ) 06/12/2022 Common Stock 3,334 $ 0 0 D
Non-Qualified Stock Option (right to buy) $ 261.89 11/22/2019 M 13,889 ( 6 ) 06/18/2022 Common Stock 13,889 $ 0 0 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Jurvetson Stephen T
C/O TESLA, INC.
3500 DEER CREEK ROAD
PALO ALTO, CA94304
X
Signatures
By: Aaron Beckman, Power of Attorney For: Stephen T. Jurvetson 11/26/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The transactions reported herein were completed pursuant to an agreement with and for the benefit of Draper Fisher Jurvetson, of which the reporting person was formerly a managing director. All proceeds of the sale reported herein have been transferred to Draper Fisher Jurvetson.
( 2 )The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $331.98 to $332.74, inclusive. The reporting person undertakes to provide Tesla, any security holder of Tesla or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price within the range set forth in this footnote.
( 3 )These shares are owned directly by Draper Fisher Jurvetson Fund X Partners, L.P. The reporting person was formerly a managing director of the general partner entities of these funds that directly hold shares and as such the reporting person may have been deemed to have voting and investment power with respect to such shares. The reporting person disclaims beneficial ownership with respect to such shares except to the extent of his pecuniary interest therein.
( 4 )These shares are owned by the Steve Jurvetson TR UA 1/29/19 Future Venture Living Trust. Reflects a prior transfer of 52,100 shares to the reporting person's former wife pursuant to a divorce decree.
( 5 )This stock option award is a triennial equity award granted pursuant to the Company's 2010 Equity Incentive Plan and Outside Director Compensation Policy. 1/36th of the shares granted became vested and exercisable as of each monthly anniversary of June 12, 2015, such that all shares subject to the Option became fully vested and exercisable by June 12, 2018.
( 6 )This stock option award is a triennial equity award granted pursuant to the Company's 2010 Equity Incentive Plan and Outside Director Compensation Policy. 1/36th of the shares granted became vested and exercisable as of each monthly anniversary of June 18, 2015, such that all shares subject to the Option became fully vested and exercisable by June 18, 2018.

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