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 |
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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). |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol AMYRIS, INC. [ AMRS ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Date of Earliest Transaction (Month/Day/Year) 04/20/2017 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 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 | 04/20/2017 | J(1) | 64,178,185 | D | (1) | 0 | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 | ||||||||
1.5% Senior Convertible Note | $3.08(2) | 04/20/2017 | J(1) | $3,700,000(2) | (2) | (2) | Common Stock | (2) | (1) | 0 | D | ||||
6.5% Convertible Senior Notes Due 2019 | $3.74(3) | 04/20/2017 | J(1) | $9,705,000(3) | (3) | (3) | Common Stock | (3) | (1) | 0 | D | ||||
Tranche I Senior Convertible Note | $2.44(4) | 04/20/2017 | J(1) | $9,252,184.41(4) | (4) | (4) | Common Stock | (4) | (1) | 0 | D | ||||
Tranche II Senior Convertible Note | $2.87(5) | 04/20/2017 | J(1) | $6,042,064.77(5) | (5) | (5) | Common Stock | (5) | (1) | 0 | D | ||||
Warrants (right to buy) | $0.01 | 04/20/2017 | J(1) | 2,000,000(6) | (6) | 07/29/2020 | Common Stock | 2,000,000(6) | (1) | 0 | D | ||||
Warrants (right to buy) | $0.01 | 04/20/2017 | J(1) | 128,205(6) | (6) | 07/29/2020 | Common Stock | 128,205(6) | (1) | 0 | D |
Explanation of Responses: |
1. The securities reported herein were transferred by the Reporting Person to Total Raffinage Chimie, an affiliated entity of the Reporting Person, in connection with a reorganization of the Reporting Person and affiliated entities, and may not be considered a sale of securities under Section l6(b). The parent of the Reporting Person, Total S.A., continues to beneficially own the securities reported herein. |
2. The principal amount of this note is $3,700,000, and the initial conversion price is $3.08 per share, subject to adjustment as set forth therein. This note is convertible only in those circumstances described in the note. The Final Maturity Date as defined in the note is March 1, 2017. |
3. The principal amount of the 6.5% Notes is $9,705,000 and the initial conversion rate is initially 267.0370 shares of Common Stock per $1,000 principal amount of Notes, subject to adjustment as set forth therein. The 6.5% Notes are convertible only in those circumstances described in the 6.5% Notes. The Final Maturity Date as defined in the 6.5% Notes is May 15, 2019. |
4. The principal amount of the Tranche I Note is $9,252,184.41. The Tranche Note is convertible only in those circumstances described in the Tranche Note. The Final Maturity Date as defined in the Tranche Note is October 16, 2018. |
5. The principal amount of the Tranche II Note is $6,042,064.77. The Tranche Note is convertible only in those circumstances described in the Tranche Note. The Final Maturity Date as defined in the Tranche Note is January 15, 2019. |
6. This warrant is exercisable upon satisfaction of the Exercise Condition as described in the warrant. |
/s/ Xavier de MAUPEOU (Managing Director) | 04/24/2017 | |
** 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. |