Sec Form 4 Filing - DOERR L JOHN @ Bloom Energy Corp - 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
DOERR L JOHN
2. Issuer Name and Ticker or Trading Symbol
Bloom Energy Corp [ BE]
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)
4353 NORTH FIRST STREET
3. Date of Earliest Transaction (MM/DD/YY)
11/22/2019
(Street)
SAN JOSE, CA95134
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
Class A common stock 11/22/2019 J( 1 ) 777,506 A $ 0 2,110,839 I By trust ( 2 )
Class A common stock 11/22/2019 J( 1 ) 12,804 A $ 0 12,804 I By trust ( 3 )
Class A common stock 11/22/2019 J( 1 ) 32,052 A $ 0 32,052 I By partnership ( 4 )
Class A common stock 11/22/2019 J( 1 ) 275,918 A $ 0 275,918 I By trust ( 5 )
Class A common stock 11/22/2019 J( 1 ) 19,255 A $ 0 19,255 I By trust ( 6 )
Class A common stock 11/22/2019 J( 1 ) 19,255 A $ 0 19,255 I By trust ( 7 )
Class A common stock 12,734 ( 8 ) D
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
Class B common stock ( 9 ) 11/22/2019 J( 1 ) 46,977 ( 9 ) ( 9 ) Class A common stock 46,977 $ 0 721,730 I Trust ( 2 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
DOERR L JOHN
4353 NORTH FIRST STREET
SAN JOSE, CA95134
X
Signatures
Shawn Soderberg as attorney in fact for the reporting person 11/26/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Pro rata distribution from KPCB Holdings, Inc. as nominee
( 2 )Held by Vallejo Ventures Trust, L. John and Ann Doerr, Trustees
( 3 )Held by the LJD Trust IX of which the reporting person is a trustee
( 4 )Held by LJD Ventures II Partnership of which the reporting person is a general partner
( 5 )Held by The 1999 Portico Trust of which reporting person is a trustee
( 6 )Held by The Hampton 1999 Trust dated May 25, 1999, of which reporting person is a trustee
( 7 )Held by The Austin 1999 Trust dated May 25, 1999, of which reporting person is a trustee
( 8 )Represents restricted stock units issued under the Bloom Energy Corporation 2018 Equity Incentive Plan. The RSUs will vest on the date of the next annual stockholders meeting, subject to continued service of the reporting person through such date.
( 9 )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 any transfer except certain permitted transfers. All the outstanding shares of Class B Common Stock will convert automatically into shares of Class A common stock upon the date that is the earliest to occur of (i) immediately prior to the close of business on the fifth anniversary of July 27, 2018, (ii) immediately prior to the close of business on the date on which the outstanding shares of Class B Common Stock represent less than five percent (5%) of the aggregate number of shares of Class A Common Stock and Class B Common Stock then outstanding, (iii) the date and time, or the occurrence of an event, specified in a written conversion election delivered by KR Sridhar to the Secretary or Chairman of the Board to so convert all shares of Class B Common Stock, or (iv) immediately following the date of the death of KR Sridhar.

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