Ocampo Susan Form 4 MACOM Technology Solutions / JOHN L OCAMPO ownership change

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

OMB APPROVAL

OMB Number:	3235-0287
Estimated average burden
hours per response:	0.5

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^*

OCAMPO JOHN L

(Last) (First) (Middle)

C/O MACOM TECHNOLOGY SOLUTIONS HOLDINGS

100 CHELMSFORD STREET

(Street)

LOWELL MA 01851

(City) (State) (Zip)

2. Issuer Name and Ticker or Trading Symbol
MACOM Technology Solutions Holdings, Inc. [ MTSI ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	X	10% Owner
	Officer (give title below)		Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
03/04/2022

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

	Form filed by One Reporting Person
X	Form filed by More than One Reporting Person

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
Common Stock	03/04/2022		A		2,768(1)	A	$0	2,768	D
Common Stock	03/04/2022		A		2,768(1)	A	$0	2,768	I	By Susan Ocampo
Common Stock								8,358,142	I	By Ocampo Family Trust-2001(2)
Common Stock								8,988,226(3)	I	By trusts for children(2)
Common Stock								491,964	I	By John Ocampo 2021 Charitable Remainder Trust(2)
Common Stock								487,708	I	By Susan Ocampo 2021 Charitable Remainder Trust(2)

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

1. Name and Address of Reporting Person^*

OCAMPO JOHN L

(Last) (First) (Middle)

C/O MACOM TECHNOLOGY SOLUTIONS HOLDINGS

100 CHELMSFORD STREET

(Street)

LOWELL MA 01851

(City) (State) (Zip)

1. Name and Address of Reporting Person^*

OCAMPO SUSAN

(Last) (First) (Middle)

C/O MACOM TECHNOLOGY SOLUTIONS HOLDINGS

100 CHELMSFORD STREET

(Street)

LOWELL MA 01851

(City) (State) (Zip)

Explanation of Responses:

1. Represents restricted stock units granted to the Reporting Persons under the Issuer's 2021 Omnibus Incentive Plan. Each restricted stock unit represents the contingent right to receive one share of Common Stock. The restricted stock units vest in full on March 4, 2023, provided that the Reporting Persons remain in continuous service with the Issuer through the vesting date.

2. The Reporting Persons are trustees of the Ocampo Family Trust-2001, the John Ocampo 2021 Charitable Remainder Trust, the Susan Ocampo 2021 Charitable Remainder Trust, and each of the following three trusts for the benefit of their children: (i) a trust for their son; (ii) a trust for their daughter; and (iii) a trust for their son.

3. 2,747,742 of such shares are held by a trust for the Reporting Persons' son; 3,120,242 of such shares are held by a trust for the Reporting Persons' daughter; and 3,120,242 of such shares are held by a trust for the Reporting Persons' son.

Remarks:

	/s/ Ambra R. Roth, Attorney-in-Fact for John Ocampo and Susan Ocampo	03/08/2022
	** 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.