0001209191-19-058213.txt : 20191126
0001209191-19-058213.hdr.sgml : 20191126
20191126193239
ACCESSION NUMBER: 0001209191-19-058213
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191122
FILED AS OF DATE: 20191126
DATE AS OF CHANGE: 20191126
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DOERR L JOHN
CENTRAL INDEX KEY: 0001032455
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38598
FILM NUMBER: 191252735
MAIL ADDRESS:
STREET 1: C/O KLEINER PERKINS CAUFIELD & BYERS
STREET 2: 2750 SAND HILL ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
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
2019-11-22
0
0001664703
Bloom Energy Corp
BE
0001032455
DOERR L JOHN
4353 NORTH FIRST STREET
SAN JOSE
CA
95134
1
0
0
0
Class A common stock
2019-11-22
4
J
0
777506
0.00
A
2110839
I
By trust
Class A common stock
2019-11-22
4
J
0
12804
0.00
A
12804
I
By trust
Class A common stock
2019-11-22
4
J
0
32052
0.00
A
32052
I
By partnership
Class A common stock
2019-11-22
4
J
0
275918
0.00
A
275918
I
By trust
Class A common stock
2019-11-22
4
J
0
19255
0.00
A
19255
I
By trust
Class A common stock
2019-11-22
4
J
0
19255
0.00
A
19255
I
By trust
Class A common stock
12734
D
Class B common stock
2019-11-22
4
J
0
46977
0.00
A
Class A common stock
46977
721730
I
Trust
Pro rata distribution from KPCB Holdings, Inc. as nominee
Held by Vallejo Ventures Trust, L. John and Ann Doerr, Trustees
Held by the LJD Trust IX of which the reporting person is a trustee
Held by LJD Ventures II Partnership of which the reporting person is a general partner
Held by The 1999 Portico Trust of which reporting person is a trustee
Held by The Hampton 1999 Trust dated May 25, 1999, of which reporting person is a trustee
Held by The Austin 1999 Trust dated May 25, 1999, of which reporting person is a trustee
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.
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.
Shawn Soderberg as attorney in fact for the reporting person
2019-11-26