0000904454-21-000336.txt : 20210311 0000904454-21-000336.hdr.sgml : 20210311 20210311195118 ACCESSION NUMBER: 0000904454-21-000336 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210305 FILED AS OF DATE: 20210311 DATE AS OF CHANGE: 20210311 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: VAN LUNSEN GIL J CENTRAL INDEX KEY: 0001205014 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35451 FILM NUMBER: 21735000 MAIL ADDRESS: STREET 1: C/O HOGAN & HARTSON LLP STREET 2: 1470 WALNUT STREET SUITE 200 CITY: BOULDER STATE: CO ZIP: 80302 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MACOM Technology Solutions Holdings, Inc. CENTRAL INDEX KEY: 0001493594 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 270306875 STATE OF INCORPORATION: DE FISCAL YEAR END: 1001 BUSINESS ADDRESS: STREET 1: 100 CHELMSFORD STREET CITY: LOWELL STATE: MA ZIP: 01851 BUSINESS PHONE: (978) 656-2500 MAIL ADDRESS: STREET 1: 100 CHELMSFORD STREET CITY: LOWELL STATE: MA ZIP: 01851 FORMER COMPANY: FORMER CONFORMED NAME: M/A-COM Technology Solutions Holdings, Inc. DATE OF NAME CHANGE: 20100607 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2021-03-05 0001493594 MACOM Technology Solutions Holdings, Inc. MTSI 0001205014 VAN LUNSEN GIL J C/O MACOM TECHNOLOGY SOLUTIONS HOLDINGS 100 CHELMSFORD STREET LOWELL MA 01851 1 0 0 0 Common Stock 2021-03-05 4 A 0 2903 0 A 35848 D Represents restricted stock awards granted to the Reporting Person under the Issuer's 2021 Omnibus Incentive Plan. Each restricted stock award represents the contingent right to receive one share of Common Stock. The restricted stock awards vest on February 15, 2022, provided that the Reporting Person remains in continuous service with the Issuer through the vesting date. /s/ Ambra R. Roth, Attorney-in-Fact 2021-03-11