SEC Form 4
FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
| |||||||||||||||
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol Lumentum Holdings Inc. [ LITE ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| ||||||||||||||||||||||||
3. Date of Earliest Transaction (Month/Day/Year) 08/07/2015 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
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 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: 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 | ||||||||
Employee Stock Option (right to buy) | $24.4 | 08/07/2015 | J(1) | V | 204 | (1) | 11/16/2015 | Common Stock | 204 | $0 | 204 | D | |||
Employee Stock Option (right to buy) | $24.4 | 08/07/2015 | J(1) | V | 682 | (1) | 11/16/2015 | Common Stock | 682 | $0 | 682 | D | |||
Restricted Stock Units | $0 | 08/07/2015 | J(2) | V | 2,579 | (2) | (3) | Common Stock | 2,579 | $0 | 2,579 | D | |||
Restricted Stock Units | $0 | 08/07/2015 | J(2) | V | 3,849 | (2) | (3) | Common Stock | 3,849 | $0 | 3,849 | D | |||
Restricted Stock Units | $0 | 08/07/2015 | J(2) | V | 6,167 | (2) | (3) | Common Stock | 6,167 | $0 | 6,167 | D |
Explanation of Responses: |
1. In connection with the spin-off of the Issuer from JDS Uniphase Corporation ("JDSU") on August 1, 2015 (the "Spin-Off"), each outstanding JDSU stock option was converted into an award of options to purchase shares of the Issuer's common stock pursuant to the terms of the employee matters agreement between JDSU and the Issuer. The number of shares and exercise prices of each option award was adjusted in a manner intended to preserve the economic value of the original JDSU stock option prior to the Spin-Off. |
2. In connection with the spin-off of the Issuer from JDS Uniphase Corporation ("JDSU") on August 1, 2015 (the "Spin-Off"), each outstanding JDSU RSU award was converted into a RSU award denominated in shares of the Issuer's common stock pursuant to the terms of the employee matters agreement between JDSU and the Issuer. The number of underlying shares was adjusted in a manner intended to preserve the economic value of the original JDSU RSU award prior to the Spin-Off. Each RSU represents a contingent right to receive one share of the Issuer's underlying common stock. |
3. Restricted Stock Units have no expiration date. |
/s/ Judy G Hamel as Attorney-in-Fact | 08/11/2015 | |
** 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 Number. |