0000950103-18-011874.txt : 20181010 0000950103-18-011874.hdr.sgml : 20181010 20181010162426 ACCESSION NUMBER: 0000950103-18-011874 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181005 FILED AS OF DATE: 20181010 DATE AS OF CHANGE: 20181010 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Henderson Michael Roy CENTRAL INDEX KEY: 0001674618 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50646 FILM NUMBER: 181116218 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 dp96796_4-henderson.xml FORM 4 X0306 4 2018-10-05 1 0001275014 Ultra Clean Holdings, Inc. UCTT 0001674618 Henderson Michael Roy ULTRA CLEAN HOLDINGS, INC. 26462 CORPORATE AVE HAYWARD CA 94545 0 1 0 0 SVP, Engineering Common Stock 2018-10-05 4 S 0 33976 D 13810 D Represents unvested restricted stock units that were forfeited back to the Company upon the reporting person's termination as part of a larger severance arrangement that included the payment of $154,940 with respect to unvested units. /s/ Marty Estkowski, as attorney-in-fact for Michael Roy Henderson 2018-10-10