0001209191-19-011648.txt : 20190220 0001209191-19-011648.hdr.sgml : 20190220 20190220171245 ACCESSION NUMBER: 0001209191-19-011648 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190215 FILED AS OF DATE: 20190220 DATE AS OF CHANGE: 20190220 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BUSH MARY K CENTRAL INDEX KEY: 0001041956 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38598 FILM NUMBER: 19619301 MAIL ADDRESS: STREET 1: 3509 WOODBINE STREET CITY: CHEVY CHASE STATE: MD ZIP: 20815 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 2019-02-15 0 0001664703 Bloom Energy Corp BE 0001041956 BUSH MARY K 4353 NORTH FIRST STREET SAN JOSE CA 95134 1 0 0 0 Class A Common Stock 2019-02-15 4 C 0 15800 0.00 A 22800 D Class B Common Stock 2019-02-15 4 C 0 15800 0.00 D Class A Common Stock 15800 0 D Conversion of a derivative security pursuant to its terms. 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. /s/Shawn Soderberg, attorney-in-fact 2019-02-20