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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 |
OMB APPROVAL
OMB Number: 3235-0287 Estimated average burden hours per response... 0.5 |
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| 1. Name and Address of Reporting Person * Zuckerberg Mark | 2. Issuer Name and Ticker or Trading Symbol Facebook Inc [ FB ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner __X__ Officer (give title below) _____ Other (specify below) COB and CEO |
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3. Date of Earliest Transaction
(MM/DD/YYYY)
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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 |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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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 | ||||||
| Class A Common Stock | 11/8/2019 | S(1) | 48835 | D | $190.4359 (2) | 4021728 | I | By Chan Zuckerberg Foundation (3) | ||
| Class A Common Stock | 11/8/2019 | S(1) | 38618 | D | $191.4922 (4) | 3983110 | I | By Chan Zuckerberg Foundation (3) | ||
| Class A Common Stock | 11/8/2019 | S(1) | 7547 | D | $192.0498 (5) | 3975563 | I | By Chan Zuckerberg Foundation (3) | ||
| Class A Common Stock | 11/8/2019 | C | 19000 | A | $0 | 19000 | I | By CZI Holdings, LLC (6) | ||
| Class A Common Stock | 11/8/2019 | S(1) | 10220 | D | $190.4548 (7) | 8780 | I | By CZI Holdings, LLC (6) | ||
| Class A Common Stock | 11/8/2019 | S(1) | 7745 | D | $191.547 (8) | 1035 | I | By CZI Holdings, LLC (6) | ||
| Class A Common Stock | 11/8/2019 | S(1) | 1035 | D | $192.1343 (9) | 0 | I | By CZI Holdings, LLC (6) | ||
| Class A Common Stock | 11/8/2019 | S(10) | 1075 | D | $190.4295 (11) | 89834 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 2 Dated 5/8/2014 (12) | ||
| Class A Common Stock | 11/8/2019 | S(10) | 730 | D | $191.5844 (13) | 89104 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 2 Dated 5/8/2014 (12) | ||
| Class A Common Stock | 11/8/2019 | S(10) | 45 | D | $192.14 | 89059 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 2 Dated 5/8/2014 (12) | ||
| Class A Common Stock | 11/8/2019 | S(10) | 1227 | D | $190.4062 (14) | 118232 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 3 Dated 5/8/2014 (15) | ||
| Class A Common Stock | 11/8/2019 | S(10) | 973 | D | $191.5102 (16) | 117259 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 3 Dated 5/8/2014 (15) | ||
| Class A Common Stock | 11/8/2019 | S(10) | 50 | D | $192.12 | 117209 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 3 Dated 5/8/2014 (15) | ||
| Class A Common Stock | 103000 | I | By Chan Zuckerberg Advocacy (17) | |||||||
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
| 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 | ||||||||
| Class B Common Stock (18) | (18) | 11/8/2019 | C | 19000 | (18) | (18) | Class A Common Stock | 19000 | $0 | 356003925 | I | By CZI Holdings, LLC (6) | |||
| Class B Common Stock (18) | (18) | (18) | (18) | Class A Common Stock | 1908602 | 1908602 | I | By Chan Zuckerberg Foundation (3) | |||||||
| Class B Common Stock (18) | (18) | (18) | (18) | Class A Common Stock | 5676058 | 5676058 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg Trust Dated July 7, 2006 (19) | |||||||
| Reporting Owners | |||||
| Reporting Owner Name / Address | |||||
| Director | 10% Owner | Officer | Other | ||
| Zuckerberg Mark C/O FACEBOOK, INC. 1601 WILLOW ROAD MENLO PARK, CA 94025 | X | X | COB and CEO | ||
| Signatures | ||
| /s/ Michael Johnson as attorney-in-fact for Mark Zuckerberg | 11/12/2019 | |
| **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. | |