0001437749-23-015881.txt : 20230525 0001437749-23-015881.hdr.sgml : 20230525 20230525171353 ACCESSION NUMBER: 0001437749-23-015881 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230525 FILED AS OF DATE: 20230525 DATE AS OF CHANGE: 20230525 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jensen Mark Edwin CENTRAL INDEX KEY: 0001560798 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18032 FILM NUMBER: 23961975 MAIL ADDRESS: STREET 1: 6303 SNOWBERRY LANE CITY: NIWOT STATE: CO ZIP: 80503 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: LATTICE SEMICONDUCTOR CORP CENTRAL INDEX KEY: 0000855658 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 930835214 STATE OF INCORPORATION: DE FISCAL YEAR END: 1230 BUSINESS ADDRESS: STREET 1: 5555 NE MOORE CT CITY: HILLSBORO STATE: OR ZIP: 97124 BUSINESS PHONE: 5032688000 MAIL ADDRESS: STREET 1: 5555 NE MOORE CT CITY: HILLSBORO STATE: OR ZIP: 97124 4 1 rdgdoc.xml FORM 4 X0407 4 2023-05-25 0000855658 LATTICE SEMICONDUCTOR CORP LSCC 0001560798 Jensen Mark Edwin 5555 NE MOORE COURT HILLSBORO OR 97124 1 0 Common Stock 2023-05-25 4 G 0 62565 0 D 63197 I See Footnote (1)(2) Common Stock 38677 D The Reporting Person's most recent Form 4, filed May 10, 2023, with a transaction date of May 8, 2023, reported 101,874 shares of Common Stock held directly following the transactions reported in such Form 4 (the "05/08/23 Shares"). Of the 05/08/23 Shares, 63,197 shares are held by Genesis Property, LLC ("Genesis LLC"), of which the Reporting Person was the sole member and manager. The outstanding membership interests of Genesis LLC are comprised of 100 Class A units and 9,900 Class B units. On May 25, 2023, the 9,900 Class B units held by Genesis LLC were transferred by gift to the Jensen Family 2023 Irrevocable Trust (the "Trust"), for the benefit of the Reporting Person's spouse and descendants. For SEC purposes only, 62,565 of the 05/08/23 Shares are attributable to the Class B units of Genesis LLC and, therefore, the Trust has an interest in such 62,565 shares. (continued in footnote 2) (continued from footnote 1) For SEC purposes only, the Reporting Person disclaims beneficial ownership of such 62,565 shares except to the extent of his pecuniary interest therein. The Reporting Person has the power to vote and dispose of all shares held by Genesis LLC and the Reporting Person has included all such shares as indirectly held in Column 6 of this Form 4. 38,677 of the of the 05/08/23 Shares are held directly by the Reporting Person. /s/ Tracy Feanny, Attorney in Fact For: Mark Edwin Jensen 2023-05-25