0000950103-17-001921.txt : 20170228 0000950103-17-001921.hdr.sgml : 20170228 20170228191546 ACCESSION NUMBER: 0000950103-17-001921 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170226 FILED AS OF DATE: 20170228 DATE AS OF CHANGE: 20170228 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Ultra Clean Holdings, Inc. CENTRAL INDEX KEY: 0001275014 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 611430858 STATE OF INCORPORATION: DE FISCAL YEAR END: 1230 BUSINESS ADDRESS: STREET 1: 26462 CORPORATE AVENUE CITY: HAYWARD STATE: CA ZIP: 94545 BUSINESS PHONE: (510) 576-4400 MAIL ADDRESS: STREET 1: 26462 CORPORATE AVENUE CITY: HAYWARD STATE: CA ZIP: 94545 FORMER COMPANY: FORMER CONFORMED NAME: ULTRA CLEAN HOLDINGS INC DATE OF NAME CHANGE: 20031231 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEV LAVI CENTRAL INDEX KEY: 0001103963 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50646 FILM NUMBER: 17650648 MAIL ADDRESS: STREET 1: C/O ULTRA CLEAN HOLDINGS INC. STREET 2: 26462 CORPORATE AVENUE CITY: HAYWARD STATE: CA ZIP: 94545 4 1 dp73450_4-lev.xml FORM 4 X0306 4 2017-02-26 0 0001275014 Ultra Clean Holdings, Inc. UCTT 0001103963 LEV LAVI ULTRA CLEAN HOLDINGS, INC. 26462 CORPORATE AVE HAYWARD CA 94545 0 1 0 0 SVP, Asia Common Stock 2017-02-26 4 F 0 881 14.67 D 111733 D Common Stock 2017-02-26 4 F 0 3182 14.67 D 108551 D Represents shares withheld for payment of tax liability arising as a result of the partial settlement of a performance restricted stock unit award originally reported by the reporting person on the Form 4 filed with the Commission on February 17, 2017. Represents shares withheld for payment of tax liability arising as a result of the partial settlement of a restricted stock unit award originally reported by the reporting person on the Form 4 filed with the Commission on March 1, 2016. /s/ Sheri Brumm, as attorney-in-fact for Lavi Lev 2017-02-28