0001365916-12-000089.txt : 20120905 0001365916-12-000089.hdr.sgml : 20120905 20120905200729 ACCESSION NUMBER: 0001365916-12-000089 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120831 FILED AS OF DATE: 20120905 DATE AS OF CHANGE: 20120905 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DOERR L JOHN CENTRAL INDEX KEY: 0001032455 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34885 FILM NUMBER: 121075162 MAIL ADDRESS: STREET 1: C/O KLEINER PERKINS CAUFIELD & BYERS STREET 2: 2750 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMYRIS, INC. CENTRAL INDEX KEY: 0001365916 STANDARD INDUSTRIAL CLASSIFICATION: INDUSTRIAL ORGANIC CHEMICALS [2860] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5885 HOLLIS ST SUITE 100 CITY: EMERYVILLE STATE: CA ZIP: 94608 BUSINESS PHONE: 510-450-0761 MAIL ADDRESS: STREET 1: 5885 HOLLIS ST SUITE 100 CITY: EMERYVILLE STATE: CA ZIP: 94608 FORMER COMPANY: FORMER CONFORMED NAME: AMYRIS BIOTECHNOLOGIES INC DATE OF NAME CHANGE: 20060613 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2012-08-31 0001365916 AMYRIS, INC. AMRS 0001032455 DOERR L JOHN C/O KLEINER PERKINS CAUFIELD & BYERS 2750 SAND HILL ROAD MENLO PARK CA 94025 1 0 0 0 Common Stock 2012-08-31 4 P 0 270270 3.70 A 1347185 I By Foris Ventures, LLC Common Stock 6000 D Common Stock 144707 I By Clarus, LLC Common Stock 3724558 I By Kleiner Perkins Caufield & Byers XII, LLC Common Stock 67952 I By KPCB XII Founders Fund, LLC Common Stock 8503 I The Vallejo Ventures Trust U/T/A 2/12/96 The Reporting Person indirectly holds all of the membership interests in Foris Ventures, LLC. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. The Reporting Person is the manager of Clarus, LLC. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. The shares are held for convenience in the name of "KPCB Holdings, Inc., as nominee" for the account of entities affiliated with Kleiner Perkins Caufield & Byers and others. KPCB Holdings, Inc. has no voting, dispositive or pecuniary interest in any such shares. The General Partner of Kleiner Perkins Caufield & Byers XII, LLC is KPCB XII Associates, LLC, of which the Reporting Person is a managing member. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. The shares are held for convenience in the name of "KPCB Holdings, Inc., as nominee" for the account of entities affiliated with Kleiner Perkins Caufield & Byers and others. KPCB Holdings, Inc. has no voting, dispositive or pecuniary interest in any such shares. The General Partner of KPCB XII Founders Fund, LLC is KPCB XII Associates, LLC, of which the Reporting Person is a managing member. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. The shares are held for convenience in the name of "KPCB Holdings, Inc., as nominee" for the account of entities affiliated with Kleiner Perkins Caufield & Byers and others. KPCB Holdings, Inc. has no voting, dispositive or pecuniary interest in any such shares. The Reporting Person transferred this stock to The Vallejo Ventures Trust U/T/A 2/12/96 on August 21, 2012. The Reporting Person is a Trustee of The Vallejo Ventures Trust U/T/A 2/12/96. /s/ L. John Doerr by Nicholas Khadder, Attorney-in-Fact 2012-09-05