0000904454-21-000761.txt : 20211105 0000904454-21-000761.hdr.sgml : 20211105 20211105191631 ACCESSION NUMBER: 0000904454-21-000761 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211104 FILED AS OF DATE: 20211105 DATE AS OF CHANGE: 20211105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dennehy Robert CENTRAL INDEX KEY: 0001588004 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35451 FILM NUMBER: 211386127 MAIL ADDRESS: STREET 1: 100 CHELMSFORD STREET 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: 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 2021-11-04 0001493594 MACOM Technology Solutions Holdings, Inc. MTSI 0001588004 Dennehy Robert C/O MACOM TECHNOLOGY SOLUTIONS HOLDINGS 100 CHELMSFORD STREET LOWELL MA 01851 0 1 0 0 SVP, Operations Common Stock 2021-11-04 4 A 0 12003 0 A 82703 D Common Stock 2021-11-04 4 A 0 20493 0 A 103196 D Common Stock 2021-11-04 4 A 0 70002 0 A 173198 D Common Stock 2021-11-04 4 A 0 7863 0 A 181061 D Common Stock 2021-11-04 4 F 0 48947 74.52 D 132114 D Represents performance-based restricted stock units ("PRSUs") granted to the Reporting Person on October 29, 2019 under the Issuer's 2012 Omnibus Incentive Plan, which vested and settled in shares of Common Stock on November 4, 2021. Reflects an adjustment of two shares to account for a rounding-based de minimus discrepancy relating to the transactions reported by the Reporting Person on a Form 4 filed on November 6, 2020. Represents PRSUs granted to the Reporting Person on November 6, 2018 under the Issuer's 2012 Omnibus Incentive Plan, which vested and settled in shares of Common Stock on November 4, 2021. Represents PRSUs granted to the Reporting Person on November 19, 2018 under the Issuer's 2012 Omnibus Incentive Plan, which vested and settled in shares of Common Stock on November 4, 2021. Represents PRSUs granted to the Reporting Person on October 28, 2020 under the Issuer's 2012 Omnibus Incentive Plan, which vested and settled in shares of Common Stock on November 4, 2021. Shares withheld by the Issuer to satisfy the Reporting Person's tax withholding obligations in connection with the vesting and settling of PRSUs on November 4, 2021. /s/ Ambra R. Roth, Attorney-in-Fact 2021-11-05