0000899243-23-010972.txt : 20230407 0000899243-23-010972.hdr.sgml : 20230407 20230407170007 ACCESSION NUMBER: 0000899243-23-010972 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230406 FILED AS OF DATE: 20230407 DATE AS OF CHANGE: 20230407 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: VERHALEN ANDREW W CENTRAL INDEX KEY: 0001205979 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35667 FILM NUMBER: 23809154 MAIL ADDRESS: STREET 1: C/O MATRIX PARTNERS STREET 2: 250 HOMER AVE SUITE 201 CITY: PALO ALTO STATE: CA ZIP: 94301 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMBARELLA INC CENTRAL INDEX KEY: 0001280263 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 980459628 FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 3101 JAY STREET CITY: SANTA CLARA STATE: CA ZIP: 95054 BUSINESS PHONE: 408-734-8888 MAIL ADDRESS: STREET 1: 3101 JAY STREET CITY: SANTA CLARA STATE: CA ZIP: 95054 4 1 doc4.xml FORM 4 SUBMISSION X0407 4 2023-04-06 0 0001280263 AMBARELLA INC AMBA 0001205979 VERHALEN ANDREW W 260 HOMER AVENUE, SUITE 201 PALO ALTO CA 94301 1 0 0 0 0 Ordinary Shares 2023-04-06 4 M 0 5555 16.35 A 78957 D Ordinary Shares 11455 I By Andrew W. Verhalen and Janet L. Brownstone Trust 12/01/1989 Ordinary Shares 850 I By Nicole Brownstone Verhalen 1997 Trust Ordinary Shares 850 I By Sara Rose Verhalen 1997 Trust Stock Option (right to buy) 16.35 2023-04-06 4 M 0 5555 0.00 D 2023-06-05 Ordinary Shares 5555 0 D Shares subject to the option vested monthly over one year beginning on June 6, 2013. /s/ Michael Morehead by Power of Attorney 2023-04-07