Statement of Changes in Beneficial Ownership (4)
May 17 2019 - 4:46PM
Edgar (US Regulatory)
FORM 4
[
X
]
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
*
Lough Emily
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2. Issuer Name
and
Ticker or Trading Symbol
MAXWELL TECHNOLOGIES INC
[
MXWL
]
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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)
VP, General Counsel&Secretary
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(Last)
(First)
(Middle)
3888 CALLE FORTUNADA
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3. Date of Earliest Transaction
(MM/DD/YYYY)
5/16/2019
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(Street)
SAN DIEGO, CA 92123
(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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Common Stock
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5/16/2019
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U
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11674
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D
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(1)
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0
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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)
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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
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(2)
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5/16/2019
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D
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6871
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(2)
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(3)
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Common Stock
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6871
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$0.00
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0
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D
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Restricted Stock Units
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(4)
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5/16/2019
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D
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25000
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(4)
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(3)
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Common Stock
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25000
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$0.00
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0
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D
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Restricted Stock Units
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(5)
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5/16/2019
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D
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11250
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(5)
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(3)
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Common Stock
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11250
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$0.00
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0
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D
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Market Stock Units
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(6)
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5/16/2019
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D
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11250
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(6)
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(3)
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Common Stock
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11250
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$0.00
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0
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D
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Restricted Stock Units
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(7)
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5/16/2019
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D
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9375
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(7)
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(3)
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Common Stock
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9375
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$0.00
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0
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D
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Market Stock Units
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(8)
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5/16/2019
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D
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11876
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(8)
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(3)
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Common Stock
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11876
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$0.00
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0
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D
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Restricted Stock Units
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(9)
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5/16/2019
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D
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5778
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(9)
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(3)
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Common Stock
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5778
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$0.00
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0
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D
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Restricted Stock Units
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(10)
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5/16/2019
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D
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500
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(10)
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(3)
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Common Stock
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500
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$0.00
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0
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D
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Employee Stock Options (Right to Buy)
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(11)
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5/16/2019
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D
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3000
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(11)
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2/10/2020
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Common Stock
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3000
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$0.00
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0
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D
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Explanation of Responses:
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(1)
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Pursuant to the Agreement and Plan of Merger, dated as of February 3, 2019 (the "Merger Agreement"), by and among Tesla, inc. ("Tesla"), Cambria Acquisition Corp. and the Issuer, each share of common stock was tendered in exchange for 0.0193 of a share of Tesla common stock, together with cash in lieu of any fractional shares of Tesla common stock. Upon consummation of the tender offer, the Reporting Person received Transaction Consideration of 225 shares of Tesla common stock and $75.79 in lieu of fractional shares of Tesla common stock.
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(2)
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Each restricted stock unit (RSU) represents a right to receive one share of the Issuer's common stock. This award represents RSUs received
under the short-term incentive bonus plan which are fully vested upon grant. The award was assumed by Tesla in the merger and converted
into fully vested restricted stock units representing a right to receive an aggregate of 132 shares of the Common Stock of Tesla.
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(3)
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These units do not expire.
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(4)
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Each restricted stock unit (RSU) represents a right to receive one share of the Issuer's common stock. The RSU, which vests in annual installments over 4 years beginning February 20, 2020, was assumed by Tesla in the merger and converted into restricted stock units representing a contingent right to receive an aggregate of 482 shares of the Common Stock of Tesla on the same terms and conditions (including with respect to vesting and exercisability) as were applicable to the RSU prior to the consummation of the merger.
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(5)
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Each restricted stock unit (RSU) represents a right to receive one share of the Issuer's common stock. The RSU, which vests in annual installments over 4 years beginning February 20, 2019, was assumed by Tesla in the merger and converted into restricted stock units representing a contingent right to receive an aggregate of 217 shares of the Common Stock of Tesla on the same terms and conditions (including with respect to vesting and exercisability) as were applicable to the RSU prior to the consummation of the merger.
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(6)
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Each market stock unit (MSU) represents a right to receive one share of the Issuer's common stock. The MSUs vest based on performance of
the Company's common stock compared to the Nasdaq Composite Index over a period of three years. Depending on the level of performance
actually achieved, the number of shares that may vest under this award will vary. The amount included in the table above represents the target
number of shares which vest upon a change in control, and therefore vest in connection with the Merger Agreement and are assumed by Tesla
in the merger and converted into fully vested restricted stock units representing a right to receive an aggregate of 217 shares of the Common
Stock of Tesla.
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(7)
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Each restricted stock unit (RSU) represents a right to receive one share of the Issuer's common stock. The RSU, which vests in annual installments over 4 years beginning February 20, 2018, was assumed by Tesla in the merger and converted into restricted stock units representing a contingent right to receive an aggregate of 180 shares of the Common Stock of Tesla on the same terms and conditions (including with respect to vesting and exercisability) as were applicable to the RSU prior to the consummation of the merger.
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(8)
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Each market stock unit (MSU) represents a right to receive one share of the Issuer's common stock. The MSUs vest based on performance of the Company's common stock compared to the Nasdaq Composite Index over a period of three years. Depending on the level of performance actually achieved, the number of shares that may vest under this award will vary. The amount included in the table above represents the target number of shares which vest upon a change in control, and therefore vest in connection with the Merger Agreement and are assumed by Tesla in the merger and converted into fully vested restricted stock units representing a right to receive an aggregate of 229 shares of the Common Stock of Tesla.
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(9)
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Each restricted stock unit (RSU) represents a right to receive one share of the Issuer's common stock. The RSU, which vests in annual installments over 4 years beginning January 15, 2017, was assumed by Tesla in the merger and converted into restricted stock units representing a contingent right to receive an aggregate of 111 shares of the Common Stock of Tesla on the same terms and conditions (including with respect to vesting and exercisability) as were applicable to the RSU prior to the consummation of the merger.
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(10)
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Each restricted stock unit (RSU) represents a right to receive one share of the Issuer's common stock. The RSU, which vests in annual installments over 4 years beginning March 13, 2016, was assumed by Tesla in the merger and converted into restricted stock units representing a contingent right to receive an aggregate of 9 shares of the Common Stock of Tesla on the same terms and conditions (including with respect to vesting and exercisability) as were applicable to the RSU prior to the consummation of the merger.
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(11)
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Option becomes exercisable over 4 years beginning March 10, 2011 as long as holder remains in service to the Company. The option was assumed by Tesla in the merger and replaced with an option to purchase 57 shares of Tesla Common Stock with an exercise price of $813.99 per share.
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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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Lough Emily
3888 CALLE FORTUNADA
SAN DIEGO, CA 92123
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VP, General Counsel&Secretary
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Signatures
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/s/ Emily Lough
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5/17/2019
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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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