Sec Form 4 - Statement Of Changes In Beneficial Ownership
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35/10/2016
SEC FORM 4
SEC Form 4
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
FORM 4
OMB APPROVAL
Washington, D.C. 20549
OMB Number:
32350287
Estimated average burden
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Check this box if no longer subject
hours per response:
0.5
to Section 16. Form 4 or Form 5
X
obligations may continue. See
Instruction 1(b).
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
*
2. Issuer Name and Ticker or Trading Symbol
5. Relationship of Reporting Person(s) to Issuer
1. Name and Address of Reporting Person
Facebook Inc [
]
(Check all applicable)
FB
DST Global III, L.P.
X
Director
10% Owner
Officer (give title
Other (specify
3. Date of Earliest Transaction (Month/Day/Year)
below)
below)
(Last)
(First)
(Middle)
05/22/2012
C/O TULLOCH & CO., 4 HILL STREET
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check
Applicable Line)
(Street)
Form filed by One Reporting Person
LONDON
X0
W1J5NE
Form filed by More than One Reporting
X
Person
(City)
(State)
(Zip)
Table I NonDerivative Securities Acquired, Disposed of, or Beneficially Owned
2. Transaction
2A. Deemed
3.
4. Securities Acquired (A) or
5. Amount of
6. Ownership
7. Nature
1. Title of Security (Instr. 3)
Date
Execution Date,
Transaction
Disposed Of (D) (Instr. 3, 4 and 5)
Securities
Form: Direct
of Indirect
(Month/Day/Year)
if any
Code
Beneficially
(D) or
Beneficial
(Month/Day/Year)
(Instr. 8)
Owned Following
Indirect (I)
Ownership
Reported
(Instr. 4)
(Instr. 4)
(A) or
Transaction(s)
Code
V
Amount
Price
(D)
(Instr. 3 and 4)
Class A Common Stock
05/22/2012
590,337
D
$37.582
1,106,880
D
(1)
S
See
Class A Common Stock
05/22/2012
17,750,421
D
$37.582
30,372,774
I
S
Footnote
(2)
Table II Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of
2.
3. Transaction
3A. Deemed
4.
5. Number
6. Date Exercisable and
7. Title and
8. Price
9. Number of
10.
11. Nature
Derivative
Conversion
Date
Execution Date,
Transaction
of
Expiration Date
Amount of
of
derivative
Ownership
of Indirect
Security
or
(Month/Day/Year)
if any
Code (Instr.
Derivative
(Month/Day/Year)
Securities
Derivative
Securities
Form:
Beneficial
(Instr. 3)
Exercise
(Month/Day/Year)
8)
Securities
Underlying
Security
Beneficially
Direct (D)
Ownership
Price of
Acquired
Derivative
(Instr. 5)
Owned
or Indirect
(Instr. 4)
Derivative
(A) or
Security
Following
(I) (Instr.
Security
Disposed
(Instr. 3 and
Reported
4)
of (D)
4)
Transaction(s)
(Instr. 3,
(Instr. 4)
4 and 5)
Amount
or
Number
Date
Expiration
of
Code
V
(A)
(D)
Exercisable
Date
Title
Shares
*
1. Name and Address of Reporting Person
DST Global III, L.P.
(Last)
(First)
(Middle)
C/O TULLOCH & CO., 4 HILL STREET
(Street)
LONDON
X0
W1J5NE
(City)
(State)
(Zip)
*
1. Name and Address of Reporting Person
DST Managers Ltd
(Last)
(First)
(Middle)
C/O TULLOCH & CO., 4 HILL STREET
(Street)
LONDON
X0
W1J 5NE
1/3
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