0000904454-24-000209.txt : 20240312 0000904454-24-000209.hdr.sgml : 20240312 20240312165546 ACCESSION NUMBER: 0000904454-24-000209 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240308 FILED AS OF DATE: 20240312 DATE AS OF CHANGE: 20240312 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: OCAMPO SUSAN CENTRAL INDEX KEY: 0001252243 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35451 FILM NUMBER: 24743025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MACOM Technology Solutions Holdings, Inc. CENTRAL INDEX KEY: 0001493594 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] ORGANIZATION NAME: 04 Manufacturing 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 ownership.xml X0508 4 2024-03-08 0 0001493594 MACOM Technology Solutions Holdings, Inc. MTSI 0001252243 OCAMPO SUSAN 100 CHELMSFORD STREET LOWELL MA 01851 1 0 1 0 0 Common Stock 2024-03-08 4 A 0 2138 0 A 7150 D Common Stock 6886661 I By Ocampo Family Trust Common Stock 7987681 I By trusts for children Represents restricted stock units granted to the Reporting Person 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 8, 2025, provided that the Reporting Person remains in continuous service with the Issuer through the vesting date. The Reporting Person is a trustee of the Ocampo Family Trust and each of the following three trusts for the benefit of her children: (i) a trust for her son; (ii) a trust for her daughter; and (iii) a trust for her son. 2,414,227 of such shares are held by a trust for the Reporting Person's son; 2,786,727 of such shares are held by a trust for the Reporting Person's daughter; and 2,786,727 of such shares are held by a trust for the Reporting Person's son. /s/ Ambra R. Roth, Attorney-in-Fact 2024-03-12