0000904454-23-000202.txt : 20230307
0000904454-23-000202.hdr.sgml : 20230307
20230307172001
ACCESSION NUMBER: 0000904454-23-000202
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230303
FILED AS OF DATE: 20230307
DATE AS OF CHANGE: 20230307
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: OCAMPO JOHN L
CENTRAL INDEX KEY: 0001248224
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35451
FILM NUMBER: 23713827
MAIL ADDRESS:
STREET 1: 100 CHELMSFORD STREET
CITY: LOWELL
STATE: MA
ZIP: 01851
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: OCAMPO SUSAN
CENTRAL INDEX KEY: 0001252243
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35451
FILM NUMBER: 23713826
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: MACOM Technology Solutions Holdings, Inc.
CENTRAL INDEX KEY: 0001493594
STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674]
IRS NUMBER: 270306875
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0929
BUSINESS ADDRESS:
STREET 1: 100 CHELMSFORD STREET
CITY: LOWELL
STATE: MA
ZIP: 01851
BUSINESS PHONE: (978) 656-2500
MAIL ADDRESS:
STREET 1: 100 CHELMSFORD STREET
CITY: LOWELL
STATE: MA
ZIP: 01851
FORMER COMPANY:
FORMER CONFORMED NAME: M/A-COM Technology Solutions Holdings, Inc.
DATE OF NAME CHANGE: 20100607
4
1
edgar.xml
PRIMARY DOCUMENT
X0306
4
2023-03-03
0
0001493594
MACOM Technology Solutions Holdings, Inc.
MTSI
0001248224
OCAMPO JOHN L
C/O MACOM TECHNOLOGY SOLUTIONS HOLDINGS
100 CHELMSFORD STREET
LOWELL
MA
01851
1
0
1
0
0001252243
OCAMPO SUSAN
C/O MACOM TECHNOLOGY SOLUTIONS HOLDINGS
100 CHELMSFORD STREET
LOWELL
MA
01851
1
0
1
0
Common Stock
2023-03-03
4
A
0
2244
0
A
5012
D
Common Stock
2023-03-03
4
A
0
2244
0
A
5012
I
By Susan Ocampo
Common Stock
8151763
I
By Ocampo Family Trust-2001
Common Stock
7987681
I
By trusts for children
Common Stock
100468
I
By John Ocampo 2021 Charitable Remainder Trust
Common Stock
102012
I
By Susan Ocampo 2021 Charitable Remainder Trust
Represents restricted stock units granted to the Reporting Persons under the Issuer's 2021 Omnibus Incentive Plan. Each restricted stock unit represents the contingent right to receive one share of Common Stock. The restricted stock units vest in full on March 3, 2024, provided that the Reporting Persons remain in continuous service with the Issuer through the vesting date.
The Reporting Persons are trustees of the Ocampo Family Trust-2001, the John Ocampo 2021 Charitable Remainder Trust, the Susan Ocampo 2021 Charitable Remainder Trust, and each of the following three trusts for the benefit of their children: (i) a trust for their son; (ii) a trust for their daughter; and (iii) a trust for their son.
2,414,227 of such shares are held by a trust for the Reporting Persons' son; 2,786,727 of such shares are held by a trust for the Reporting Persons' daughter; and 2,786,727 of such shares are held by a trust for the Reporting Persons' son.
/s/ Ambra R. Roth, Attorney-in-Fact for John Ocampo and Susan Ocampo
2023-03-07