Statement of Changes in Beneficial Ownership (4)
02 Giugno 2023 - 01:53AM
Edgar (US Regulatory)
FORM 4
☐ Check this
box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
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OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
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Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
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1. Name
and Address of Reporting Person * Baglino Andrew
D |
2. Issuer Name and Ticker or Trading
Symbol Tesla, Inc. [ TSLA ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
SVP Powertrain and Energy Eng. |
(Last)
(First)
(Middle)
C/O TESLA, INC., 1 TESLA ROAD |
3. Date of Earliest Transaction (MM/DD/YYYY)
5/30/2023
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(Street)
AUSTIN, TX 78725 |
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line) _X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person |
(City)
(State)
(Zip)
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Rule 10b5-1(c) Transaction Indication
☒ Check this box to indicate
that a transaction was made pursuant to a contract, instruction or
written plan that is intended to satisfy the affirmative defense
conditions of Rule 10b5-1(c). See Instruction 10. |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
5/30/2023 |
|
M(1) |
|
10500 |
A |
$20.91 |
76046.75 |
D |
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Common Stock |
5/30/2023 |
|
S(1) |
|
10500 |
D |
$200.0 |
65546.75 |
D |
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Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
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1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. Code
(Instr. 8) |
5. Number of Derivative Securities Acquired (A) or
Disposed of (D)
(Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date |
7. Title and Amount of Securities Underlying
Derivative Security
(Instr. 3 and 4) |
8. Price of Derivative Security
(Instr. 5) |
9. Number of derivative Securities Beneficially
Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct
(D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Non-Qualified Stock Option (right to
buy) |
$20.91 |
5/30/2023 |
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M (1) |
|
|
10500 |
(2) |
3/19/2028 |
Common Stock |
10500 |
$0.0 |
6690 |
D |
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Explanation of
Responses: |
(1) |
The transactions reported on
this Form 4 were effected pursuant to a Rule 10b5-1 trading plan
adopted by the reporting person on November 1, 2021. |
(2) |
Represents part of a single
option award grant, including Incentive Stock Options, initially
for an aggregate 225,000 shares. 1/60th of the aggregate shares
subject to the option became vested and exercisable on March 27,
2018 and 1/60th of the shares subject to the option become vested
and exercisable on each monthly anniversary thereafter, so that all
such shares subject to this award were fully vested on February 27,
2023. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Baglino Andrew D
C/O TESLA, INC.
1 TESLA ROAD
AUSTIN, TX 78725 |
|
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SVP Powertrain and Energy Eng. |
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Signatures
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By: Aaron Beckman, Power of Attorney For: Andrew
D. Baglino |
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6/1/2023 |
**Signature of
Reporting Person |
Date |
Reminder: Report on a separate line for each class
of securities beneficially owned directly or
indirectly. |
* |
If the form is filed by more than one
reporting person, see Instruction 4(b)(v). |
** |
Intentional misstatements or omissions
of facts constitute Federal Criminal Violations. See 18
U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: |
File three copies of this Form, one of
which must be manually signed. If space is insufficient, see
Instruction 6 for procedure. |
Persons who respond to the collection of information
contained in this form are not required to respond unless the form
displays a currently valid OMB control number. |
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