Statement of Changes in Beneficial Ownership (4)
April 21 2023 - 6:16PM
Edgar (US Regulatory)
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
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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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
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DOERR L JOHN |
2. Issuer Name and Ticker or Trading Symbol
AMYRIS, INC.
[
AMRS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O 5885 HOLLIS STREET, SUITE 100 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
4/19/2023 |
(Street)
EMERYVILLE, CA 94608 |
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
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(City)
(State)
(Zip)
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Rule 10b5-1(c) Transaction Indication
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Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to
satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 4/19/2023 | | A | | 11600 (1) | A | $0 | 126047 | D | |
Common Stock | | | | | | | | 87268358 | I | by Foris Ventures, LLC (2)(3) |
Common Stock | | | | | | | | 4531 | I | by KPCB XII Founders Fund, LLC (4) |
Common Stock | | | | | | | | 248304 | I | by Kleiner Perkins Caufield and Byers XII, LLC (5) |
Common Stock | | | | | | | | 3333333 | I | by Perrara Ventures, LLC (6) |
Common Stock | | | | | | | | 9648 | I | by Clarus, LLC (7) |
Common Stock | | | | | | | | 567 | I | by The Vallejo Ventures Trust U/T/A 2/12/96 (8) |
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 |
Explanation of Responses: |
(1) | Represents a restricted stock unit award related to board and committee retainers due for services to be provided in Q2FY23, which will vest 100% on June 30, 2023. |
(2) | L. John Doerr ("John Doerr") indirectly holds all of the membership interests in Foris Ventures, LLC ("FV"). John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. |
(3) | Barbara Hager, the manager of FV, may be deemed to have sole power to vote and dispose of the shares held by FV. The Vallejo Ventures Trust U/T/A 2/12/96 ("VVT"), the member of FV, may be deemed to have sole power to vote and dispose of these securities and John Doerr and Ann Doerr, the trustees of VVT, and Barbara Hager, the special trustee of VVT, may be deemed to have shared power to vote and dispose of the reported securities. Each of John Doerr, Ann Doerr and Barbara Hager disclaims beneficial ownership of the reported securities except to the extent of their pecuniary interest therein. FV and VVT are represented on the Issuer's board of directors by John Doerr. Accordingly, each of Ann Doerr, Barbara Hager, FV and VVT are deemed to be a director by deputization. |
(4) | The Managing Member of KPCB XII Founders Fund, LLC is KPCB XII Associates, LLC, of which John Doerr is the managing member. John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. The shares are held for convenience in the name of "KPCB Holdings, Inc., as nominee" for the account of entities affiliated with Kleiner Perkins Caufield & Byers and others. KPCB Holdings, Inc. has no voting, dispositive or pecuniary interest in any such shares. |
(5) | The Managing Member of Kleiner Perkins Caufield & Byers XII, LLC is KPCB XII Associates, LLC, of which John Doerr is the managing member. John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. The shares are held for convenience in the name of "KPCB Holdings, Inc., as nominee" for the account of entities affiliated with Kleiner Perkins Caufield & Byers and others. KPCB Holdings, Inc. has no voting, dispositive or pecuniary interest in any such shares. |
(6) | John Doerr indirectly holds all of the membership interests in Perrara Ventures, LLC. John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. |
(7) | John Doerr and Ann Doerr are the trustees of VVT, which is the member of Clarus, LLC. Barbara Hager is the special trustee of VVT and manager of FV. By virtue of these relationships, John Doerr, Ann Doerr and Barbara Hager may be deemed to have the power to vote and dispose of shares held by Clarus, LLC. Each of John Doerr, Ann Doerr and Barbara Hager disclaims beneficial ownership of the shares held by Clarus, LLC except to the extent of their pecuniary interest therein, if any. |
(8) | John Doerr and Ann Doerr are the trustees of VVT. Barbara Hager is the special trustee of VVT and manager of FV. By virtue of these relationships, John Doerr, Ann Doerr and Barbara Hager may be deemed to have the power to vote and dispose of shares held by VVT. Each of John Doerr, Ann Doerr and Barbara Hager disclaims beneficial ownership of the shares held by VVT except to the extent of their pecuniary interest therein, if any. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
DOERR L JOHN C/O 5885 HOLLIS STREET, SUITE 100 EMERYVILLE, CA 94608 | X | X |
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Signatures
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/s/ L. John Doerr by Sherry Tan as Attorney-in-Fact | | 4/21/2023 |
**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. |
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