SEC Form 4
| FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
| |||||||||||||||
| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol Facebook Inc [ FB ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| ||||||||||||||||||||||||
| 3. Date of Earliest Transaction (Month/Day/Year) 07/28/2017 | ||||||||||||||||||||||||||
| 4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
| |||||||||||||||||||||||||
| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction 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 | ||||||
| Class A Common Stock | 07/28/2017 | C | 45,659 | A | $0 | 45,659 | I | By The Founders Fund IV, LP(1) | ||
| Class A Common Stock | 07/28/2017 | S(2) | 1,816 | D | $169.486(3) | 43,843 | I | By The Founders Fund IV, LP(1) | ||
| Class A Common Stock | 07/28/2017 | S(2) | 1,135 | D | $170.4923(4) | 42,708 | I | By The Founders Fund IV, LP(1) | ||
| Class A Common Stock | 07/28/2017 | S(2) | 14,817 | D | $171.9049(5) | 27,891 | I | By The Founders Fund IV, LP(1) | ||
| Class A Common Stock | 07/28/2017 | S(2) | 27,284 | D | $172.6701(6) | 607 | I | By The Founders Fund IV, LP(1) | ||
| Class A Common Stock | 07/28/2017 | S(2) | 607 | D | $173.2676(7) | 0 | I | By The Founders Fund IV, LP(1) | ||
| Class A Common Stock | 07/28/2017 | C | 14,657 | A | $0 | 14,657 | I | By The Founders Fund IV Principals Fund, LP(8) | ||
| Class A Common Stock | 07/28/2017 | S(2) | 584 | D | $169.4861(3) | 14,073 | I | By The Founders Fund IV Principals Fund, LP(8) | ||
| Class A Common Stock | 07/28/2017 | S(2) | 365 | D | $170.4924(4) | 13,708 | I | By The Founders Fund IV Principals Fund, LP(8) | ||
| Class A Common Stock | 07/28/2017 | S(2) | 4,747 | D | $171.904(5) | 8,961 | I | By The Founders Fund IV Principals Fund, LP(8) | ||
| Class A Common Stock | 07/28/2017 | S(2) | 8,765 | D | $172.6703(6) | 196 | I | By The Founders Fund IV Principals Fund, LP(8) | ||
| Class A Common Stock | 07/28/2017 | S(2) | 196 | D | $173.2672(7) | 0 | I | By The Founders Fund IV Principals Fund, LP(8) | ||
| Class A Common Stock | 6,311 | D | ||||||||
| Class A Common Stock | 214,407 | I | By Rivendell One LLC(9) | |||||||
| Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) | 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: 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 | ||||||||
| Class B Common Stock(10) | (10) | 07/28/2017 | C | 45,659(11) | (10) | (10) | Class A Common Stock | 45,659 | $0 | 41,631(12) | I | By The Founders Fund IV, LP(1) | |||
| Class B Common Stock(10) | (10) | 07/28/2017 | C | 14,657(11) | (10) | (10) | Class A Common Stock | 14,657 | $0 | 13,364(12) | I | By The Founders Fund IV Principals Fund, LP(8) | |||
| Explanation of Responses: |
| 1. The reporting person is one of the Managers of The Founders Fund IV Management, LLC ("FF IV Management"), which is the General Partner of The Founders Fund IV, LP ("FF IV"), although he disclaims voting and investment power over the securities held by FF IV. The reporting person otherwise disclaims beneficial ownership over such securities except to the extent of his pecuniary interest therein. The inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. |
| 2. The sales reported on this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the holder. |
| 3. The reported price in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $169.07 to $169.89 per share, inclusive. The holder undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon written request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. |
| 4. The reported price in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $170.21 to $171.00 per share, inclusive. The holder undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon written request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. |
| 5. The reported price in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $171.22 to $172.19 per share, inclusive. The holder undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon written request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. |
| 6. The reported price in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $172.23 to $173.21 per share, inclusive. The holder undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon written request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. |
| 7. The reported price in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $173.23 to $173.40 per share, inclusive. The holder undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon written request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. |
| 8. The reporting person is one of the Managers of FF IV Management, which is the General Partner of The Founders Fund IV Principals Fund, LP ("FFIVPF"), although he disclaims voting and investment power over the securities held by FFIVPF. The reporting person otherwise disclaims beneficial ownership over such securities except to the extent of his pecuniary interest therein. The inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. |
| 9. The reporting person is the beneficial owner of Rivendell One LLC ("Rivendell"), and has sole voting and investment power over the securities held by Rivendell. |
| 10. 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 certain transfers of such shares and has no expiration date. |
| 11. The holder elected to convert the shares of Class B Common Stock into Class A Common Stock on a 1-for-1 basis. |
| 12. Includes shares to be received by the holder in connection with the acquisition of Oculus by the issuer pursuant to the agreement and plan of merger (the "Merger Agreement"), which are currently being held in escrow and are subject to forfeiture during the escrow period stated to satisfy claims arising as a result of, among other things, Oculus' breach of any of its representations and warranties or covenants and agreements set forth in the Merger Agreement. |
| /s/ David Kling as attorney-in-fact for Peter Thiel | 08/01/2017 | |
| ** 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 Number. | ||