0000904454-20-000248.txt : 20200225 0000904454-20-000248.hdr.sgml : 20200225 20200225165413 ACCESSION NUMBER: 0000904454-20-000248 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200221 FILED AS OF DATE: 20200225 DATE AS OF CHANGE: 20200225 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CARLSON DOUGLAS J CENTRAL INDEX KEY: 0001719731 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35451 FILM NUMBER: 20651629 MAIL ADDRESS: STREET 1: MACOM TECHNOLOGY SOLUTIONS HOLDINGS INC. STREET 2: 100 CHELMSFORD ST. CITY: LOWELL STATE: MA ZIP: 01851 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: 0927 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 2020-02-21 0001493594 MACOM Technology Solutions Holdings, Inc. MTSI 0001719731 CARLSON DOUGLAS J C/O MACOM TECHNOLOGY SOLUTIONS HOLDINGS 100 CHELMSFORD STREET LOWELL MA 01851 0 1 0 0 SVP, Technology Common Stock 2020-02-21 4 M 0 600 2.00 A 53548 D Stock Option (Right to Buy) 2.00 2020-02-21 4 M 0 600 0 D 2020-08-14 Common Stock 600 0 D The Stock Option vested in full on August 1, 2014. /s/ Ambra R. Roth, Attorney-in-Fact 2020-02-25