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MTSI MACOM Technology Solutions Holdings Inc

102.85
3.87 (3.91%)
04 May 2024 - Closed
Delayed by 15 minutes
Share Name Share Symbol Market Type
MACOM Technology Solutions Holdings Inc NASDAQ:MTSI NASDAQ Common Stock
  Price Change % Change Share Price Bid Price Offer Price High Price Low Price Open Price Shares Traded Last Trade
  3.87 3.91% 102.85 102.85 105.79 103.92 101.60 103.92 629,777 01:00:00

Statement of Changes in Beneficial Ownership (4)

01/03/2021 9:45pm

Edgar (US Regulatory)


FORM 4 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).         
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
                                                                                  
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response...
0.5                       
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

OCAMPO JOHN L
2. Issuer Name and Ticker or Trading Symbol

MACOM Technology Solutions Holdings, Inc. [ MTSI ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

__X__ Director                    __X__ 10% Owner
__X__ Officer (give title below)    _____ Other (specify below)
Chairman
(Last)          (First)          (Middle)

C/O MACOM TECHNOLOGY SOLUTIONS HOLDINGS, 100 CHELMSFORD STREET
3. Date of Earliest Transaction (MM/DD/YYYY)

2/26/2021
(Street)

LOWELL, MA 01851
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
6. Individual or Joint/Group Filing (Check Applicable Line)

___ Form filed by One Reporting Person
_ X _ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 2/26/2021  G  V 1000000 D$0 8533142 I By Ocampo Family Trust-2001 (1)
Common Stock 2/26/2021  G  V 500000 A$0 500000 I By John Ocampo 2021 Charitable Remainder Trust (1)
Common Stock 2/26/2021  G  V 500000 A$0 500000 I By Susan Ocampo 2021 Charitable Remainder Trust (1)
Common Stock         3047742 I By trust for son (1)
Common Stock         3220242 I By trust for daughter (1)
Common Stock         3220242 I By trust for son (1)

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security3. Trans. Date3A. Deemed Execution Date, if any4. Trans. Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
6. Date Exercisable and Expiration Date7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)11. Nature of Indirect Beneficial Ownership (Instr. 4)
CodeV(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares

Explanation of Responses:
(1) 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 the trusts for the benefit of their children.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
OCAMPO JOHN L
C/O MACOM TECHNOLOGY SOLUTIONS HOLDINGS
100 CHELMSFORD STREET
LOWELL, MA 01851
XXChairman
OCAMPO SUSAN
C/O MACOM TECHNOLOGY SOLUTIONS HOLDINGS
100 CHELMSFORD STREET
LOWELL, MA 01851
XX


Signatures
/s/ Ambra R. Roth, Attorney-in-Fact for John Ocampo and Susan Ocampo3/1/2021
**Signature of Reporting PersonDate

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