0001664703-21-000132.txt : 20210804 0001664703-21-000132.hdr.sgml : 20210804 20210804182559 ACCESSION NUMBER: 0001664703-21-000132 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210802 FILED AS OF DATE: 20210804 DATE AS OF CHANGE: 20210804 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CHAMBERS JOHN T CENTRAL INDEX KEY: 0001198044 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38598 FILM NUMBER: 211145567 MAIL ADDRESS: STREET 1: 170 W. TASMAN DR. CITY: SAN JOSE STATE: CA ZIP: 95134-1706 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 FISCAL YEAR END: 1231 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 wf-form4_162811593471001.xml FORM 4 X0306 4 2021-08-02 0 0001664703 Bloom Energy Corp BE 0001198044 CHAMBERS JOHN T 4353 NORTH FIRST STREET SAN JOSE CA 95134 1 0 0 0 Class A Common Stock 2021-08-02 4 M 0 4444 0 A 96956 D Class A Common Stock 333333 I By LLC Restricted Stock Units 2021-08-02 4 M 0 4444 0 D Class A Common Stock 4444.0 0 D Held by JCEP Investments, LLC of which the reporting person is the managing member. Each restricted stock unit (the "RSU") represents a contingent right to receive one (1) share of the Class A Common Stock of the Issuer upon settlement. The RSU will vest 34% on the first anniversary of August 1, 2018; 33% will vest on the second anniversary of August 1, 2018; and 33% will vest on the third anniversary of August 1, 2018, subject to the reporting person's continued service with the Issuer through each vesting date. /s/ Shawn M. Soderberg, as attorney-in-fact 2021-08-04