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