0001209191-19-037305.txt : 20190614 0001209191-19-037305.hdr.sgml : 20190614 20190614193736 ACCESSION NUMBER: 0001209191-19-037305 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190612 FILED AS OF DATE: 20190614 DATE AS OF CHANGE: 20190614 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Powell Colin CENTRAL INDEX KEY: 0001603044 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38598 FILM NUMBER: 19900160 MAIL ADDRESS: STREET 1: THE LANDMARK @ ONE MARKET STREET STREET 2: SUITE 300 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Bloom Energy Corp CENTRAL INDEX KEY: 0001664703 STANDARD INDUSTRIAL CLASSIFICATION: ELECTRICAL INDUSTRIAL APPARATUS [3620] IRS NUMBER: 770565408 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 4353 NORTH FIRST STREET CITY: SAN JOSE STATE: CA ZIP: 95134 BUSINESS PHONE: 408-543-1500 MAIL ADDRESS: STREET 1: 4353 NORTH FIRST STREET CITY: SAN JOSE STATE: CA ZIP: 95134 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-06-12 0 0001664703 Bloom Energy Corp BE 0001603044 Powell Colin 4353 NORTH FIRST STREET SAN JOSE CA 95134 1 0 0 0 Class A Common Stock 2019-06-12 4 C 0 90968 0.00 A 90968 I By trust Class A Common Stock 2019-06-12 4 C 0 11523 0.00 A 11523 I By trust Class A Common Stock 346067 D Class B Common Stock 0.00 2019-06-12 4 C 0 90968 0.00 D Class A Common Stock 90968 0 I By trust Class B common stock 0.00 2019-06-12 4 C 0 11523 0.00 D Class A Common Stock 11523 0 I By trust All of the outstanding shares of Class B Common Stock will convert automatically into shares of Class A Common Stock upon the occurrence of certain events. In addition, Class B Common Stock may be converted into shares of Class A Common Stock at any time at the election of the holder. Held by The Colin L. Powell Revocable Trust U/A DTD 01/26/2006 Held by The 2016 CLP 4-Year GRAT U/A DTD 10/16/2016 Colin Powell Trustee Shawn Soderberg as attorney in fact for Colin Powell 2019-06-14