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
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OMB APPROVAL
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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 |
C/O FACEBOOK, INC., 1601 WILLOW ROAD |
3. Date of Earliest Transaction
(MM/DD/YYYY)
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MENLO PARK, CA 94025 |
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 | 4/11/2017 | C | 71531 | A | $0 | 71531 | I | By Chan Zuckerberg Foundation (1) | ||
Class A Common Stock | 4/11/2017 | S (2) | 41474 | D | $139.5439 (3) | 30057 | I | By Chan Zuckerberg Foundation (1) | ||
Class A Common Stock | 4/11/2017 | S (2) | 26857 | D | $140.0608 (4) | 3200 | I | By Chan Zuckerberg Foundation (1) | ||
Class A Common Stock | 4/11/2017 | S (2) | 3200 | D | $140.9127 (5) | 0 | I | By Chan Zuckerberg Foundation (1) | ||
Class A Common Stock | 4/11/2017 | C | 44706 | A | $0 | 44706 | I | By CZI Holdings, LLC (6) | ||
Class A Common Stock | 4/11/2017 | S (2) | 27600 | D | $139.5658 (7) | 17106 | I | By CZI Holdings, LLC (6) | ||
Class A Common Stock | 4/11/2017 | S (2) | 15706 | D | $140.1147 (8) | 1400 | I | By CZI Holdings, LLC (6) | ||
Class A Common Stock | 4/11/2017 | S (2) | 1400 | D | $140.9357 (9) | 0 | I | By CZI Holdings, LLC (6) | ||
Class A Common Stock | 4/11/2017 | S (10) | 27464 | D | $139.6338 (11) | 512617 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 1 Dated 5/8/2014 (12) | ||
Class A Common Stock | 4/11/2017 | S (10) | 8201 | D | $140.3317 (13) | 504416 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 1 Dated 5/8/2014 (12) | ||
Class A Common Stock | 4/11/2017 | S (10) | 100 | D | $141.00 | 504316 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 1 Dated 5/8/2014 (12) | ||
Class A Common Stock | 4/11/2017 | S (10) | 11483 | D | $139.5732 (14) | 984038 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 2 Dated 5/8/2014 (15) | ||
Class A Common Stock | 4/11/2017 | S (10) | 6200 | D | $140.176 (16) | 977838 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 2 Dated 5/8/2014 (15) | ||
Class A Common Stock | 4/11/2017 | S (10) | 200 | D | $140.90 | 977638 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 2 Dated 5/8/2014 (15) | ||
Class A Common Stock | 4/11/2017 | S (10) | 13962 | D | $139.6522 (17) | 1077990 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 3 Dated 5/8/2014 (18) | ||
Class A Common Stock | 4/11/2017 | S (10) | 3920 | D | $140.3458 (19) | 1074070 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 3 Dated 5/8/2014 (18) | ||
Class A Common Stock | 4/12/2017 | C | 71500 | A | $0 | 71500 | I | By Chan Zuckerberg Foundation (1) | ||
Class A Common Stock | 4/12/2017 | S (2) | 71500 | D | $139.8584 (20) | 0 | I | By Chan Zuckerberg Foundation (1) | ||
Class A Common Stock | 4/12/2017 | C | 44688 | A | $0 | 44688 | I | By CZI Holdings, LLC (6) | ||
Class A Common Stock | 4/12/2017 | S (2) | 44688 | D | $139.857 (21) | 0 | I | By CZI Holdings, LLC (6) | ||
Class A Common Stock | 4/12/2017 | S (10) | 35750 | D | $139.86 (22) | 468566 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 1 Dated 5/8/2014 (12) | ||
Class A Common Stock | 4/12/2017 | S (10) | 17874 | D | $139.8624 (23) | 959764 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 2 Dated 5/8/2014 (15) | ||
Class A Common Stock | 4/12/2017 | S (10) | 17875 | D | $139.8541 (24) | 1056195 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg 2014 GRAT No. 3 Dated 5/8/2014 (18) |
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 | ||||||||
Class B Common Stock (25) | (25) | 4/11/2017 | C | 71531 | (25) | (25) | Class A Common Stock | 71531 | $0 | 3801840 | I | By Chan Zuckerberg Foundation (1) | |||
Class B Common Stock (25) | (25) | 4/11/2017 | C | 44706 | (25) | (25) | Class A Common Stock | 44706 | $0 | 401633288 | I | By CZI Holdings, LLC (6) | |||
Class B Common Stock (25) | (25) | 4/12/2017 | C | 71500 | (25) | (25) | Class A Common Stock | 71500 | $0 | 3730340 | I | By Chan Zuckerberg Foundation (1) | |||
Class B Common Stock (25) | (25) | 4/12/2017 | C | 44688 | (25) | (25) | Class A Common Stock | 44688 | $0 | 401588600 | I | By CZI Holdings, LLC (6) | |||
Class B Common Stock (25) | (25) | (25) | (25) | Class A Common Stock | 5207492 | 5207492 | I | By Mark Zuckerberg, Trustee Of The Mark Zuckerberg Trust Dated July 7, 2006 (26) |
Reporting Owners
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Reporting Owner Name / Address |
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Director | 10% Owner | Officer | Other | ||
Zuckerberg Mark
C/O FACEBOOK, INC. 1601 WILLOW ROAD MENLO PARK, CA 94025 |
X | X | COB and CEO |
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Signatures
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/s/ Michael Johnson as attorney-in-fact for Mark Zuckerberg | 4/13/2017 | |
** Signature of Reporting Person |
Date
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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. |
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