0001104659-18-048493.txt : 20180731
0001104659-18-048493.hdr.sgml : 20180731
20180731191339
ACCESSION NUMBER: 0001104659-18-048493
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180727
FILED AS OF DATE: 20180731
DATE AS OF CHANGE: 20180731
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Future Fund Board of Guardians
CENTRAL INDEX KEY: 0001505790
STATE OF INCORPORATION: C3
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38598
FILM NUMBER: 18982455
BUSINESS ADDRESS:
STREET 1: LEVEL 43, 120 COLLINS STREET
CITY: MELBOURNE
STATE: C3
ZIP: VIC 3000
BUSINESS PHONE: 61 03 8656 6400
MAIL ADDRESS:
STREET 1: LEVEL 43, 120 COLLINS STREET
CITY: MELBOURNE
STATE: C3
ZIP: VIC 3000
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Future Fund Investment Co No.5 Pty Ltd
CENTRAL INDEX KEY: 0001748685
STATE OF INCORPORATION: C3
FISCAL YEAR END: 0630
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38598
FILM NUMBER: 18982456
BUSINESS ADDRESS:
STREET 1: LEVEL 42, 120 COLLINS STREET
CITY: MELBOURNE
STATE: C3
ZIP: VIC 3000
BUSINESS PHONE: 61 03 8656 6400
MAIL ADDRESS:
STREET 1: LEVEL 42, 120 COLLINS STREET
CITY: MELBOURNE
STATE: C3
ZIP: VIC 3000
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: 1299 ORLEANS DRIVE
CITY: SUNNYVALE
STATE: CA
ZIP: 94089
BUSINESS PHONE: 408-543-1500
MAIL ADDRESS:
STREET 1: 1299 ORLEANS DRIVE
CITY: SUNNYVALE
STATE: CA
ZIP: 94089
4
1
a4.xml
4
X0306
4
2018-07-27
0
0001664703
Bloom Energy Corp
BE
0001505790
Future Fund Board of Guardians
LEVEL 42, 120 COLLINS STREET
MELBOURNE
C3
VIC 3000
AUSTRALIA
0
0
1
0
0001748685
Future Fund Investment Co No.5 Pty Ltd
LEVEL 42, 120 COLLINS STREET
MELBOURNE
C3
VIC 3000
AUSTRALIA
0
0
1
0
8% Convertible Preferred Notes
2018-07-27
4
C
0
1022566
D
Series G Convertible Preferred Stock
1022566
0
I
See Footnote
Series G Convertible Preferred Stock
2018-07-27
4
C
0
1022566
D
Class B Common Stock
1022566
3881988
I
See Footnote
Series G Convertible Preferred Stock
2018-07-27
4
C
0
3881988
D
Class B Common Stock
3881988
0
I
See Footnote
Class B Common Stock
2018-07-27
4
C
0
4904554
A
Class A Common Stock
4904554
4904554
I
See Footnote
Upon the completion of the Issuer's initial public offering ("IPO"), the outstanding 8% Convertible Preferred Notes mandatorily converted into shares of Series G Convertible Preferred Stock and then converted automatically into shares of Class B Common Stock in connection with the Issuer's IPO on a 1:1 basis.
The number of shares reflect both the principle and the interest accrued through July 24, 2018.
The securities are held of record by The Northern Trust Company in its capacity as custodian for Future Fund Investment Company No.5 Pty Ltd. By virtue of Future Fund Board of Guardians being the parent of Future Fund Investment Company No.5 Pty Ltd, Future Fund Board of Guardians may be deemed to share beneficial ownership of the securities beneficially held by Future Fund Investment Company No.5 Pty Ltd. Each Reporting Person disclaims beneficial ownership with respect to securities directly beneficially owned by the other Reporting Person, except to the extent of its pecuniary interest therein, if any.
In connection with the IPO, the shares of Series G Convertible Preferred converted automatically into shares of Class B Common Stock on a 1:1 basis.
The securities are held of record by The Northern Trust Company in its capacity as custodian for Future Fund Board of Guardians.
Each outstanding share of Class B Common Stock is convertible at any time at the option of the holder into one share of Class A Common Stock. In addition, each share of Class B Common Stock will convert automatically into one share of Class A Common Stock upon any transfer, whether or not for value, which occurs after the closing of the IPO, except for certain permitted transfers described in the Issuer's restated certificate of incorporation.
3,881,988 of these shares are held of record by The Northern Trust Company in its capacity as custodian for Future Fund Board of Guardians. 1,022,566 of these shares are held of record by The Northern Trust Company in its capacity as custodian for Future Fund Investment Company No.5 Pty Ltd. By virtue of Future Fund Board of Guardians being the parent of Future Fund Investment Company No.5 Pty Ltd, Future Fund Board of Guardians may be deemed to share beneficial ownership of the securities beneficially held by Future Fund Investment Company No.5 Pty Ltd. Each Reporting Person disclaims beneficial ownership with respect to securities directly beneficially owned by the other Reporting Person, except to the extent of its pecuniary interest therein, if any.
/s/ Cameron Price, Authorized Signatory for Future Fund Board of Guardians
2018-07-31
/s/ Paul Mann, Authorized Signatory for Future Fund Investment Company No.5 Pty Ltd
2018-07-31