Statement of Changes in Beneficial Ownership (4)
October 18 2019 - 6:11PM
Edgar (US Regulatory)
FORM 4
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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
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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
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Venkataraman Swaminathan |
2. Issuer Name and Ticker or Trading Symbol
Bloom Energy Corp
[
BE
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) EVP of Engineering and CTO
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(Last)
(First)
(Middle)
4353 NORTH FIRST STREET |
3. Date of Earliest Transaction
(MM/DD/YYYY)
10/16/2019
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(Street)
SAN JOSE, CA 95134
(City)
(State)
(Zip)
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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
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Class A common stock
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10/16/2019
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M
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10000
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A
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$0.00
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181387
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D
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Class A common stock
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10/17/2019
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S(1)
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5031
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D
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$2.9388 (2)
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176356
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D
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Class A common stock
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389146
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I
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By trust (3)
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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)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code (Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)
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8. Price of Derivative Security (Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Restricted stock units (Class A common stock)
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(4)
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10/16/2019
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M
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10000
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(5)
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10/16/2028
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Class A common stock
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10000
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$0.00
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40000
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D
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Explanation of Responses:
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(1)
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Sale of shares to cover taxes incurred as a result of the vesting of RSUs, in accordance with a Rule 10b5-1 trading plan entered into by reporting person
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(2)
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The price reported is a weighted average price. These shares were sold in multiple transactions at prices ranging from $2.86 to $2.965, inclusive. The reporting person undertakes to provide Bloom Energy Corporation, any security holder of Bloom Energy Corporation, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth above.
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(3)
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Held by The Venkataraman Living Trust UTA dtd 6/8/2011 of which the reporting person is a trustee
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(4)
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Each Class A common stock RSU represents a contingent right to receive 1 share of the Issuer's Class A Common Stock upon settlement.
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(5)
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The RSUs vest in equal annual installments of 10,000 shares on each of October 16, 2019, 2020, 2021, 2022 and 2023, subject to the reporting person's continuous service with the issuer.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Venkataraman Swaminathan 4353 NORTH FIRST STREET SAN JOSE, CA 95134
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EVP of Engineering and CTO
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Signatures
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By Shawn Soderberg as attorney in fact for the reporting person
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10/18/2019
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**Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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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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