0000950103-17-008278.txt : 20170829 0000950103-17-008278.hdr.sgml : 20170829 20170829161517 ACCESSION NUMBER: 0000950103-17-008278 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170825 FILED AS OF DATE: 20170829 DATE AS OF CHANGE: 20170829 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEV LAVI CENTRAL INDEX KEY: 0001103963 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50646 FILM NUMBER: 171058134 MAIL ADDRESS: STREET 1: C/O ULTRA CLEAN HOLDINGS INC. STREET 2: 26462 CORPORATE AVENUE CITY: HAYWARD STATE: CA ZIP: 94545 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Ultra Clean Holdings, Inc. CENTRAL INDEX KEY: 0001275014 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 611430858 STATE OF INCORPORATION: DE FISCAL YEAR END: 1230 BUSINESS ADDRESS: STREET 1: 26462 CORPORATE AVENUE CITY: HAYWARD STATE: CA ZIP: 94545 BUSINESS PHONE: (510) 576-4400 MAIL ADDRESS: STREET 1: 26462 CORPORATE AVENUE CITY: HAYWARD STATE: CA ZIP: 94545 FORMER COMPANY: FORMER CONFORMED NAME: ULTRA CLEAN HOLDINGS INC DATE OF NAME CHANGE: 20031231 4 1 dp79767_4-lev.xml FORM 4 X0306 4 2017-08-25 0 0001275014 Ultra Clean Holdings, Inc. UCTT 0001103963 LEV LAVI ULTRA CLEAN HOLDINGS, INC. 26462 CORPORATE AVE HAYWARD CA 94545 0 1 0 0 President, Asia Common Stock 2017-08-25 4 A 0 10000 0 A 109566 D Restricted stock units vest over 3 years with equal parts vesting on each anniversary of the vesting commencement date of August 25, 2017. /s/ Sheri Brumm as attorney-in-fact for Lavi Lev 2017-08-29