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*
DOERR L JOHN

(Last) (First) (Middle)
C/O 1180 SAN CARLOS AVENUE, #717

(Street)
SAN CARLOS CA 94070

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
AMYRIS, INC. [ AMRS ]
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)
06/05/2023
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
Rule 10b5-1(c) Transaction Indication

  
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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
2019 LSA $3 06/05/2023 D $63,014,396.78 06/05/2023 07/01/2023 Common Stock 21,004,799 (3)(4) 0 I By Foris Ventures, LLC(1)(2)
2019 LSA $3 06/05/2023 A $63,014,396.78 06/05/2023 07/01/2024 Common Stock 21,004,799 (3)(4) $63,014,396.78 I By Foris Ventures, LLC(1)(2)
1. Name and Address of Reporting Person*
DOERR L JOHN

(Last) (First) (Middle)
C/O 1180 SAN CARLOS AVENUE, #717

(Street)
SAN CARLOS CA 94070

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Foris Ventures, LLC

(Last) (First) (Middle)
1180 SAN CARLOS AVENUE, #717

(Street)
SAN CARLOS CA 94070

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Doerr Ann Howland

(Last) (First) (Middle)
1180 SAN CARLOS AVENUE, #717

(Street)
SAN CARLOS CA 94070

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Hager Barbara

(Last) (First) (Middle)
1180 SAN CARLOS AVENUE, #717

(Street)
SAN CARLOS CA 94070

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Vallejo Ventures Trust UTA 21296

(Last) (First) (Middle)
1180 SAN CARLOS AVENUE, #717

(Street)
SAN CARLOS CA 94070

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. L. John Doerr ("John Doerr ") indirectly holds all of the membership interests in Foris Ventures, LLC ("FV"). John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
2. Barbara Hager, the manager of FV, may be deemed to have sole power to vote and dispose of the shares held by FV. The Vallejo Ventures Trust U/T/A 2/12/96 ("VVT"), the member of FV, may be deemed to have sole power to vote and dispose of these securities and John Doerr and Ann Doerr, the trustees of VVT, and Barbara Hager, the special trustee of VVT, may be deemed to have shared power to vote and dispose of the reported securities. Each of John Doerr , Ann Doerr and Barbara Hager disclaims beneficial ownership of the reported securities except to the extent of their pecuniary interest therein. FV and VVT are represented on the Issuer's board of directors by John Doerr. Accordingly, each of Ann Doerr, Barbara Hager, FV and VVT are deemed to be a director by deputization.
3. On June 5, 2023, FV entered into that certain Omnibus Amendment Agreement, dated as of June 5, 2023 (the "Omnibus Amendment Agreement"), with the Issuer and the other parties thereto, to that certain Amended and Restated Loan and Security Agreement, dated as of October 28, 2019, by and between the Issuer, FV and the other parties thereto (as amended and restated from time to time, the "2019 LSA"). The Omnibus Amendment Agreement amended the 2019 LSA to extend the maturity date from July 1, 2023 to July 1, 2024, among other things. As of June 5, 2023, 16,680,334 shares of the issuer's common stock (the "Common Stock") are issuable upon conversion of the 2019 LSA in respect of an outstanding principal amount of $50.0 million and 4,324,465 shares of Common Stock are issuable upon conversion of accrued and unpaid interest of $13.0 million, reflecting a fixed conversion price of $3.00 per share of Common Stock.
4. (Continued from Footnote 3) The 2019 LSA accrues interest at 6% per annum, subject to certain default interest provisions in the event of a default under the 2019 LSA.
Remarks:
/s/ L. John Doerr, by Barbara Hager as his attorney in fact 06/07/2023
/s/ Ann Howland Doerr, by Barbara Hager as her attorney in fact 06/07/2023
/s/ Vallejo Ventures Trust UTA 21296, by Barbara Hager as Special Trustee 06/07/2023
/s/ Foris Ventures, LLC, by Barbara Hager as manager 06/07/2023
/s/ Barbara Hager 06/07/2023
** 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.