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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Option (Right to Buy) | $ 0.28 | 08/31/2012 | M | 553,730 | (2)(3) | 01/18/2017 | Common Stock | 553,730 | $ 0 | 0 | D | ||||
Stock Option (Right to Buy) | $ 0.28 | 08/31/2012 | M | 18,539 | (2)(3) | 01/18/2017 | Common Stock | 18,539 | $ 0 | 0 | I | Melo Family 2010 Distribution | |||
Stock Option (Right to Buy) | $ 0.28 | 08/31/2012 | M | 9,936 | (2)(3) | 01/18/2017 | Common Stock | 9,936 | $ 0 | 0 | I | Descendant's Trust #1 | |||
Stock Option (Right to Buy) | $ 0.28 | 08/31/2012 | M | 9,936 | (2)(3) | 01/18/2017 | Common Stock | 9,936 | $ 0 | 0 | I | Descendant's Trust #2 | |||
Stock Option (Right to Buy) | $ 0.28 | 08/31/2012 | M | 9,936 | (2)(3) | 01/18/2017 | Common Stock | 9,936 | $ 0 | 0 | I | Descendant's Trust #3 | |||
Stock Option (Right to Buy) | $ 0.28 | 08/31/2012 | M | 26,653 | (2)(3) | 01/18/2017 | Common Stock | 26,653 | $ 0 | 0 | I | Melo Renewal Trust | |||
Stock Option (Right to Buy) | $ 0.28 | 08/31/2012 | M | 40,000 | (2)(3) | 01/18/2017 | Common Stock | 40,000 | $ 0 | 0 | I | John and Mary Melo Family Foundation |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Melo John C/O AMYRIS, INC. 5885 HOLLIS ST., SUITE 100 EMERYVILLE, CA 94608 |
X | President and CEO |
/s/ John Melo by Nicholas Khadder, Attorney-in-Fact | 09/05/2012 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Reflects private sale of Issuer Common Stock to certain existing investors. |
(2) | Immediately exercisable. |
(3) | The stock option vested as to 1/5th of the total number of shares subject to the option on October 23, 2007, and thereafter vested as to 1/60th of the total number of shares subject to the option in equal monthly installments. |