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*
DOERR L JOHN

(Last) (First) (Middle)
C/O 5885 HOLLIS STREET, SUITE 100

(Street)
EMERYVILLE CA 94608

(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)
08/14/2020
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 12/30/2022 A(1) 13,333,334 A $1.5 87,268,358 I By Foris Ventures, LLC(2)(3)
Common Stock 4,531 I By KPCB XII Founders Fund, LLC(4)
Common Stock 248,304 I By Kleiner Perkins Caufield & Byers XII, LLC(5)
Common Stock 3,333,333 I By Perrara Ventures, LLC(6)
Common Stock 9,648 I By Clarus, LLC(7)
Common Stock 567 I By The Vallejo Ventures Trust U/T/A 2/12/96(8)
Common Stock 106,155 D
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
6% Convertible Note due 2023 $3 08/14/2020 P $50,041,000 (9) 07/01/2023 Common Stock $50,041,000 (9) $50,041,000 I By Foris Ventures, LLC(2)(3)
Warrant (Right to Buy) $1.8 12/30/2022 A(1) 10,000,000 (10) 12/30/2027 Common Stock 10,000,000 (1) 10,000,000 I By Foris Ventures, LLC(2)(3)
1. Name and Address of Reporting Person*
DOERR L JOHN

(Last) (First) (Middle)
C/O 5885 HOLLIS STREET, SUITE 100

(Street)
EMERYVILLE CA 94608

(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)
751 LAUREL STREET
#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)
751 LAUREL STREET
#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)
751 LAUREL STREET
#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)
751 LAUREL STREET
#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. On December 29, 2022, the Issuer entered into a security purchase agreement with Foris Ventures, LLC ("FV"), pursuant to which the Issuer issued and sold to FV in a private placement (i) 13,333,334 shares of the Issuer's common stock (the "Common Stock") and (ii) a warrant to purchase up to 10,000,000 shares of Common Stock, for an aggregate purchase price of $20,000,000.
2. L. John Doerr ("John Doerr") indirectly holds all of the membership interests in FV. John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
3. 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 the Reporting Persons is deemed to be a director by deputization. The Reporting Persons are jointly filing this Form 4 pursuant to Rule 16a-3(j) under the Exchange Act.
4. The Managing Member of KPCB XII Founders Fund, LLC is KPCB XII Associates, LLC, of which John Doerr is the managing member. John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. The shares are held for convenience in the name of "KPCB Holdings, Inc., as nominee" for the account of entities affiliated with Kleiner Perkins Caufield & Byers and others. KPCB Holdings, Inc. has no voting, dispositive or pecuniary interest in any such shares.
5. The Managing Member of Kleiner Perkins Caufield & Byers XII, LLC is KPCB XII Associates, LLC, of which John Doerr is the managing member. John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. The shares are held for convenience in the name of "KPCB Holdings, Inc., as nominee" for the account of entities affiliated with Kleiner Perkins Caufield & Byers and others. KPCB Holdings, Inc. has no voting, dispositive or pecuniary interest in any such shares.
6. John Doerr indirectly holds all of the membership interests in Perrara Ventures, LLC. John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
7. John Doerr and Ann Doerr are the trustees of VVT, which is the member of Clarus, LLC. Barbara Hager is the special trustee of VVT and manager of FV. By virtue of these relationships, John Doerr, Ann Doerr and Barbara Hager may be deemed to have the power to vote and dispose of shares held by Clarus, LLC. Each of John Doerr, Ann Doerr and Barbara Hager disclaims beneficial ownership of the shares held by Clarus, LLC except to the extent of their pecuniary interest therein, if any.
8. John Doerr and Ann Doerr are the trustees of VVT. Barbara Hager is the special trustee of VVT and manager of FV. By virtue of these relationships, John Doerr, Ann Doerr and Barbara Hager may be deemed to have the power to vote and dispose of shares held by VVT. Each of John Doerr, Ann Doerr and Barbara Hager disclaims beneficial ownership of the shares held by VVT except to the extent of their pecuniary interest therein, if any.
9. On October 28, 2019, the Issuer, FV, as lender, and the other parties thereto entered into that certain Amended and Restated Loan and Security Agreement (the "LSA"), pursuant to which the Issuer issued certain indebtedness to FV. On June 1, 2020, the parties to the LSA entered into Amendment No. 1 thereto, pursuant to which the Issuer granted FV the right to convert, at its option, all or any portion of the indebtedness outstanding under the LSA (the "2019 Convertible Note"), including accrued and unpaid interest, into shares of Common Stock, subject to stockholder approval, which was granted on August 14, 2020. As of January 4, 2023, 16,680,334 shares of Common Stock are issuable upon conversion of the 2019 Convertible Note in respect of an outstanding principal amount of $50 million and 3,701,734 shares of Common Stock are issuable upon conversion of accrued and unpaid interest of $11.1 million, reflecting a fixed conversion price of $3.00 per share of Common Stock.
10. The warrant is exercisable at a price of $1.80 per full share of Common Stock at any time after the date of issuance for a period of five years.
Remarks:
/s/ L. John Doerr, by Barbara Hager as his attorney in fact 01/04/2023
/s/ Ann Howland Doerr, by Barbara Hager as her attorney in fact 01/04/2023
/s/ Vallejo Ventures Trust UTA 21296, by Barbara Hager as Special Trustee 01/04/2023
/s/ Foris Ventures, LLC, by Barbara Hager as manager 01/04/2023
/s/ Barbara Hager 01/04/2023
** 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).
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