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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 2270 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
Stock Option (Right to Buy) | $ 4.31 | 02/16/2011 | Â | G | Â | 50,000 | Â (1)(2) | 09/13/2019 | Common Stock | $ 0 | 0 | Â | ||
Stock Option (Right to Buy) | $ 4.31 | 02/16/2011 | Â | G | 50,000 | Â | Â (1)(2) | 09/13/2019 | Common Stock | $ 0 | 50,000 | By the Lievense Revocable Trust (4) | ||
Stock Option (Right to Buy) | $ 9.32 | 02/16/2011 | Â | G | Â | 30,000 | Â (1)(3) | 01/06/2020 | Common Stock | $ 0 | 0 | Â | ||
Stock Option (Right to Buy) | $ 9.32 | 02/16/2011 | Â | G | 30,000 | Â | Â (1)(3) | 01/06/2020 | Common Stock | $ 0 | 30,000 | By the Lievense Revocable Trust (4) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Lievense Jefferson C/O AMYRIS, INC. 5885 HOLLIS ST., SUITE 100 EMERYVILLE, CA 94608 |
 |  |  EVP of Process Development |  |
/s/ Jefferson Lievense by Nicholas Khadder, Attorney-in-Fact | 02/13/2012 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Immediately exercisable. |
(2) | The stock option vested as to 1/5th of the total number of shares subject to the option on October 1, 2009, and thereafter vested and shall vest as to 1/60th of the total number of shares subject to the option equal monthly installments. |
(3) | The stock option vested as to 1/60th of the total number of shares subject to the option on November 27, 2009, and thereafter vested and shall vest as to 1/60th of the total number of shares subject to the option equal monthly installments. |
(4) | The Reporting Person transferred this option to the Lievense Revocable Trust on February 16, 2011. The Reporting Person is a Trustee of the Lievense Revocable Trust. |