0001437749-15-014761.txt : 20150804 0001437749-15-014761.hdr.sgml : 20150804 20150804203826 ACCESSION NUMBER: 0001437749-15-014761 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150801 FILED AS OF DATE: 20150804 DATE AS OF CHANGE: 20150804 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lumentum Holdings Inc. CENTRAL INDEX KEY: 0001633978 STANDARD INDUSTRIAL CLASSIFICATION: COMMUNICATIONS EQUIPMENT, NEC [3669] IRS NUMBER: 473108385 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 430 NORTH MCCARTHY BOULEVARD CITY: MILPITAS STATE: CA ZIP: 95035 BUSINESS PHONE: 408-546-5000 MAIL ADDRESS: STREET 1: 430 NORTH MCCARTHY BOULEVARD CITY: MILPITAS STATE: CA ZIP: 95035 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: VIAVI SOLUTIONS INC. CENTRAL INDEX KEY: 0000912093 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] STATE OF INCORPORATION: DE FISCAL YEAR END: 0628 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36861 FILM NUMBER: 151027191 BUSINESS ADDRESS: STREET 1: 430 NORTH MCCARTHY BOULEVARD CITY: MILPITAS STATE: CA ZIP: 95035 BUSINESS PHONE: 4084043600 MAIL ADDRESS: STREET 1: 430 NORTH MCCARTHY BOULEVARD CITY: MILPITAS STATE: CA ZIP: 95035 FORMER NAME: FORMER CONFORMED NAME: JDS UNIPHASE CORP /CA/ DATE OF NAME CHANGE: 19990713 4 1 rdgdoc.xml FORM 4 X0306 4 2015-08-01 0001633978 Lumentum Holdings Inc. LITE 0000912093 VIAVI SOLUTIONS INC. 430 NORTH MCCARTHY BLVD. MILPITAS CA 95035 1 Common Stock 2015-08-01 5 J 0 47065189 0 D 11692855 D The Reporting Person distributed 80.1% of the outstanding shares of Issuer's common stock to its stockholders on a pro rata basis in connection with the spin-off of the Issuer from the Reporting Person on 08/01/2015. On 7/28/15, the Reporting Person's common stock of Issuer split 58,758,044-for-1,000, resulting in the Reporting Person's ownership of 58,757,044 additional shares of common stock. /s/ Judy Hamel as Attorney-in-Fact for Rex Jackson 2015-08-04