SEC FORM 4

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

1. Name and Address of Reporting Person^*

DOERR L JOHN

(Last)

(First)

(Middle)

C/O AMYRIS, INC.

5885 HOLLIS STREET, SUITE 100

(Street)

EMERYVILLE

94608

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
AMYRIS, INC. [ AMRS ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
10/09/2017

4. If Amendment, Date of Original Filed (Month/Day/Year)

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

X	Form filed by One Reporting Person
	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. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction 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)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Stock	10/09/2017		C⁽¹⁾⁽²⁾		4,877,385⁽¹⁾⁽²⁾	A	$6.3⁽¹⁾⁽²⁾	5,746,558⁽¹⁾⁽²⁾	I	By Foris Ventures, LLC⁽⁶⁾
Common Stock								3,266	D
Common Stock								9,648	I	By Clarus, LLC⁽⁷⁾
Common Stock								248,304	I	By Kleiner Perkins Caufield & Byers XII, LLC⁽⁸⁾
Common Stock								4,531	I	By KPCB XII Founders Fund, LLC⁽⁹⁾
Common Stock								567	I	By The Vallejo Ventures Trust U/T/A 2/12/96⁽¹⁰⁾

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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 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: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
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)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Series B 17.38% Convertible Preferred Stock	$17.25⁽³⁾	10/09/2017		C⁽¹⁾⁽²⁾			30,728.589	07/10/2017	⁽⁴⁾	Common Stock	1,781,368⁽³⁾	$1,000⁽⁵⁾	0	I	By Foris Ventures, LLC⁽⁶⁾

Explanation of Responses:

1. On October 9, 2017, the stated value of the Series B 17.38% Convertible Preferred Stock ("Series B Preferred Stock") held by Foris Ventures, LLC automatically converted to Common Stock at a conversion price of $17.25 per share pursuant to the terms of the Certificate of Designation of Preferences, Rights and Limitations relating to the Series B Preferred Stock ("Series B Certificate of Designation"). In addition, upon conversion of the Series B Preferred Stock, Foris Ventures, LLC was entitled to receive a payment equal to $1,738 per $1,000 of stated value of Series B Preferred Stock, which the Company elected to pay in the form of Common Stock at a price of $17.25 per share.

2. (cont'd) Pursuant to the Series B Certificate of Designation, the automatic conversion of the Series B Preferred Stock held by Foris Ventures, LLC to Common Stock will be held in abeyance to the extent such conversion would cause Foris Ventures, LLC to beneficially own in excess of 4.99% of the number of shares of Common Stock outstanding (as may be increased pursuant to the Series B Certificate of Designation, the "Beneficial Ownership Limitation"), until Foris Ventures, LLC is able to receive such shares without exceeding the Beneficial Ownership Limitation, but all rights under the Series B Certificate of Designation shall cease to apply, other than the right to convert.

3. Reflects a 1-for-15 reverse stock split which became effective on June 5, 2017.

4. Security automatically converted to Common Stock on October 9, 2017, subject to the Beneficial Ownership Limitation.

5. The security was purchased in exchange for the cancellation of $30,728,589 of existing indebtedness owed by the Issuer to Foris Ventures, LLC.

6. 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.

7. 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.

8. The Managing Member of Kleiner Perkins Caufield & Byers XII, LLC is KPCB XII Associates, LLC, of which the Reporting Person is the 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.

9. The Managing Member of KPCB XII Founders Fund, LLC is KPCB XII Associates, LLC, of which the Reporting Person is the 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.

10. The Reporting Person is a Trustee of The Vallejo Ventures Trust U/T/A 2/12/96.

Remarks:

	/s/ L. John Doerr by Stephen Dobson, Attorney-in-Fact	10/11/2017
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
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