0001209191-19-004815.txt : 20190122 0001209191-19-004815.hdr.sgml : 20190122 20190122175732 ACCESSION NUMBER: 0001209191-19-004815 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190116 FILED AS OF DATE: 20190122 DATE AS OF CHANGE: 20190122 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: 19536171 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: 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 doc4.xml FORM 4 SUBMISSION X0306 4 2019-01-16 0 0001664703 Bloom Energy Corp BE 0001603044 Powell Colin 4353 NORTH FIRST STREET SAN JOSE CA 95134 1 0 0 0 Class B Common Stock 2019-01-16 5 G 0 E 25155 0.00 D Class A Common Stock 25155 11523 I The 2016 CLP 4-Year GRAT u/a dtd 10/16/2016 Class B Common Stock 2019-01-16 5 G 0 E 25155 0.00 A Class A Common Stock 25155 53305 D Class B Common Stock 2019-01-16 5 G 0 E 6838 0.00 D Class A Common Stock 6838 0 I The CLP 6-YEAR GRAT u/a dtd 9/28/2012 Class B Common Stock 2019-01-16 5 G 0 E 6838 0.00 A Class A Common Stock 6838 60143 D All the outstanding shares of our Class B common stock will convert automatically into shares of our 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. Following such conversion, each share of Class A common stock will have one vote per share and the rights of the holders of all outstanding common stock will be identical. Colin Powell, Trustee of The 2016 CLP 4-Year GRAT u/a dtd 10/16/2016. By virtue of the relationship Mr. Powell has with the Trust, Mr. Powell is deemed to have voting and dispositive power of these shares. Colin Powell, Trustee of The CLP 6-Year GRAT u/a dtd 9/28/2012. By virtue of the relationship Mr. Powell has with the Trust, Mr. Powell is deemed to have voting and dispositive power of these shares. /s/Shawn Soderberg, attorney-in-fact 2019-01-22