SEC Form 3 · accession 0000899243-18-023315

AMYRIS, INC. · AMRS

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owners

Foris Ventures, LLC

10% Owner

Barbara Hager

10% Owner

Vallejo Ventures Trust UTA 21296

10% Owner

Ann Howland Doerr

10% Owner

Period of report

Aug 17, 2018

Accepted (ET)

Aug 27, 2018 · 5:32 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001365916

Table I — non-derivative securities

Security	Date	Code	Shares	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1,F2	holding	—	—	—	7,852,775	I	By Foris Ventures, LLC
Common Stock^F3	holding	—	—	—	567	I	By The Vallejo Ventures Trust U/T/A 2/12/96
Common Stock^F4	holding	—	—	—	5,532	I	By L. John Doerr

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
6.50% Convertible Senior Notes due 2019^F2,F5	—	holding	—	—	—	—	May 15, 2019	Common Stock	89,037	—	I
Warrant (Right to Buy)^F2,F6	$0.15	holding	—	—	—	—	—	Common Stock	64,103	—	I
Warrant (Right to Buy)^F2,F7	$0.15	holding	—	—	—	—	—	Common Stock	152,381	—	I
Warrant (Right to Buy)^F2,F8	$7.52	holding	—	—	—	—	—	Common Stock	4,877,386	—	I
Stock Option (Right to Buy)^F4	$6.96	holding	—	—	—	Aug 1, 2019	Aug 1, 2028	Common Stock	3,466	—	I
Stock Option (Right to Buy)^F4	$3.93	holding	—	—	—	Aug 2, 2018	Aug 2, 2027	Common Stock	1,733	—	I
Stock Option (Right to Buy)^F4	$6.08	holding	—	—	—	Jul 13, 2017	Jul 13, 2026	Common Stock	1,733	—	I
Stock Option (Right to Buy)^F4	$25.35	holding	—	—	—	Aug 11, 2016	Jul 13, 2026	Common Stock	400	—	I
Stock Option (Right to Buy)^F4	$57.90	holding	—	—	—	Aug 7, 2015	Aug 6, 2024	Common Stock	400	—	I
Stock Option (Right to Buy)^F4	$41.40	holding	—	—	—	Aug 8, 2014	Aug 1, 2023	Common Stock	400	—	I
Stock Option (Right to Buy)^F4	$53.25	holding	—	—	—	Aug 9, 2013	Jul 19, 2022	Common Stock	400	—	I
Stock Option (Right to Buy)^F4	$367.50	holding	—	—	—	Aug 7, 2012	Jul 19, 2021	Common Stock	400	—	I
Stock Option (Right to Buy)^F4	$452.55	holding	—	—	—	Jun 15, 2011	Mar 15, 2021	Common Stock	1,333	—	I

Explanation of responses

F1Includes 1,012,071 shares of Common Stock issuable to Foris Ventures, LLC ("Foris") following the October 9, 2017 automatic conversion of the Company's Series B 17.38% Convertible Preferred Stock ("Series B Preferred Stock") into Common Stock. Pursuant to the Series B Certificate of Designation, the automatic conversion of the Series B Preferred Stock held by Foris to Common Stock will be held in abeyance to the extent such conversion would cause Foris to beneficially own in excess of 9.99% of the number of shares of Common Stock outstanding (the "Beneficial Ownership Limitation"), until Foris is able to receive such shares without exceeding the Beneficial Ownership Limitation, but all rights under the Series B Certificate of Designation shall cease to apply, other than the right to convert.
F2The Vallejo Ventures Trust U/T/A 2/12/96 ("VVT") is the member of Foris. L. John Doerr and Ann Doerr are the trustees of VVT. Barbara Hager is the special trustee of VVT and manager of Foris. By virtue of these relationships, each of VVT, Ann Doerr and Barbara Hager may be deemed to have the power to vote and dispose of shares held by Foris. Each of VVT, Ann Doerr and Barbara Hager disclaims beneficial ownership of the shares held by Foris except to the extent of her or its pecuniary interest therein, if any.
F3L. John Doerr and Ann Doerr are the trustees of VVT. Barbara Hager is the special trustee of VVT and manager of Foris. By virtue of these relationships, Ann Doerr and Barbara Hager may be deemed to have the power to vote and dispose of shares held by VVT. Each of Ann Doerr and Barbara Hager disclaims beneficial ownership of the shares held by VVT except to the extent of her pecuniary interest therein, if any.
F4L. John Doerr is the husband of Ann Doerr.
F5The 6.50% Convertible Senior Note due 2019 held by Foris (the "Foris 6.50% Note due 2019") is convertible into shares of the Company's Common Stock at a conversion rate of 17.8073 shares per $1,000 in principal (which conversion rate is subject to adjustment in certain circumstances), representing an effective conversion price of approximately $56.16 per share. The principal amount of the Foris 6.50% Note due 2019 is $5,000,000.
F6The exercisability of the warrant was subject to the approval of the stockholders of the Issuer, which was obtained on September 17, 2015. The warrant expires on July 29, 2020.
F7The exercisability of the warrant was subject to the approval of the stockholders of the Issuer, which was obtained on May 17, 2016. The warrant expires on February 12, 2021.
F8The warrant is exercisable beginning on February 17, 2019 (the "Initial Exercise Date"), the six month anniversary of the issuance of the warrant. The warrant expires on the fifteen month anniversary of the Initial Exercise Date.