SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
ELLISON LAWRENCE JOSEPH

(Last) (First) (Middle)
C/O TESLA, INC.
3500 DEER CREEK ROAD

(Street)
PALO ALTO CA 94304

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
12/27/2018
3. Issuer Name and Ticker or Trading Symbol
Tesla, Inc. [ TSLA ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 3,000,000 I Ellison Revoc Trust(1)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. The reporting person indirectly beneficially owns a total of 3,000,000 shares through the Lawrence J Ellison Revocable Trust u/a 1/22/88, as amended.
By: Aaron Beckman, Power of Attorney For: Lawrence J. Ellison 01/07/2019
** 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 5 (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.
LIMITED POWER OF ATTORNEY - FOR SECTION 16(a) REPORTING
The undersigned, as a member of the Board of Directors of 
Tesla, Inc. (the "Company"), hereby constitutes and appoints 
the following Company employees: Dane Butswinkas, Jonathan 
Chang, Yun Huh, Aaron Beckman and each of them, the 
undersigned's true and lawful attorney-in-fact and agent 
(with full power of substitution and resubstitution, each 
with the power to act alone for the undersigned and in the 
undersigned's name, place and stead) to complete, execute 
and submit to the SEC such Forms 3, 4 and 5 and other forms 
as such attorney shall in his descretion determine to be 
required or advisable pursuant to Section 16(a) of the 
Securities Exchange Act of 1934 (as ammended) and the rules 
and regulations promulgated thereunder, or any successor 
laws and regulations, as a consequence of the undersigned's 
ownership, acquisition or disposition of equity securities of 
the Company, and to do all acts necessary in order to file such 
forms with the Securities and Exchange Commission, any 
securities exchange or national association, the Company 
and such other person or agency as the attorney shall deem 
appropriate.
This Limited Power of Attorney shall remain in full force
 and 
effect until the undersigned is no longer required to file Forms 
4 and 5 with respect to the undersigned's holdings of and 
transactions in securities issued by the Company unless earlier 
revoked by the undersigned in a writing delivered to the 
foregoing attorneys-in-fact.
This Limited Power of Attorney is executed at Redwood City, CA, 
as of the date set forth below.

/s/Lawrence J. Ellison
January 7, 2019