# EDGAR Filing Document

**Accession Number:** 0001365916
**File Stem:** 0000899243-23-000770
**Filing Date:** 2023-1
**Character Count:** 16905
**Document Hash:** 68e962a97b106124b8e9e081956f252f
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0000899243-23-000770.hdr.sgml**: 20230104

**ACCESSION NUMBER**: 0000899243-23-000770

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20200814

**FILED AS OF DATE**: 20230104

**DATE AS OF CHANGE**: 20230104

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** DOERR L JOHN
- **CENTRAL INDEX KEY:** 0001032455
- **STATE OF INCORPORATION:** CA
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34885
- **FILM NUMBER:** 23509599

**MAIL ADDRESS:**
- **STREET 1:** C/O KLEINER PERKINS CAUFIELD & BYERS
- **STREET 2:** 2750 SAND HILL ROAD
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Foris Ventures, LLC
- **CENTRAL INDEX KEY:** 0001749713
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34885
- **FILM NUMBER:** 23509598

**BUSINESS ADDRESS:**
- **STREET 1:** 751 LAUREL STREET, #717
- **CITY:** SAN CARLOS
- **STATE:** CA
- **ZIP:** 94070
- **BUSINESS PHONE:** 650-384-0240

**MAIL ADDRESS:**
- **STREET 1:** 751 LAUREL STREET, #717
- **CITY:** SAN CARLOS
- **STATE:** CA
- **ZIP:** 94070
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Doerr Ann Howland
- **CENTRAL INDEX KEY:** 0001750962

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34885
- **FILM NUMBER:** 23509597

**MAIL ADDRESS:**
- **STREET 1:** 751 LAUREL STREET, #717
- **CITY:** SAN CARLOS
- **STATE:** CA
- **ZIP:** 94070
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Hager Barbara
- **CENTRAL INDEX KEY:** 0001750733

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34885
- **FILM NUMBER:** 23509596

**MAIL ADDRESS:**
- **STREET 1:** 751 LAUREL STREET, #717
- **CITY:** SAN CARLOS
- **STATE:** CA
- **ZIP:** 94070
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Vallejo Ventures Trust UTA 21296
- **CENTRAL INDEX KEY:** 0001750751
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34885
- **FILM NUMBER:** 23509595

**BUSINESS ADDRESS:**
- **STREET 1:** 751 LAUREL STREET, #717
- **CITY:** SAN CARLOS
- **STATE:** CA
- **ZIP:** 94070
- **BUSINESS PHONE:** 6503840240

**MAIL ADDRESS:**
- **STREET 1:** 751 LAUREL STREET, #717
- **CITY:** SAN CARLOS
- **STATE:** CA
- **ZIP:** 94070
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** AMYRIS, INC.
- **CENTRAL INDEX KEY:** 0001365916
- **STANDARD INDUSTRIAL CLASSIFICATION:** INDUSTRIAL ORGANIC CHEMICALS [2860]
- **IRS NUMBER:** 550856151
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 5885 HOLLIS STREET, SUITE 100
- **CITY:** EMERYVILLE
- **STATE:** CA
- **ZIP:** 94608
- **BUSINESS PHONE:** 510-450-0761

**MAIL ADDRESS:**
- **STREET 1:** 5885 HOLLIS STREET, SUITE 100
- **CITY:** EMERYVILLE
- **STATE:** CA
- **ZIP:** 94608

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** AMYRIS BIOTECHNOLOGIES INC
- **DATE OF NAME CHANGE:** 20060613

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>DOERR L JOHN<br><sub>(Last) (First) (Middle)</sub><br>C/O 5885 HOLLIS STREET, SUITE 100<br><sub>(Street)</sub><br>EMERYVILLE, CA 94608<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2020-08-14 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>AMYRIS, INC. [ AMRS ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Foris Ventures, LLC<br><sub>(Last) (First) (Middle)</sub><br>751 LAUREL STREET

#717<br><sub>(Street)</sub><br>SAN CARLOS, CA 94070<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2020-08-14 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>AMYRIS, INC. [ AMRS ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Doerr Ann Howland<br><sub>(Last) (First) (Middle)</sub><br>751 LAUREL STREET

#717<br><sub>(Street)</sub><br>SAN CARLOS, CA 94070<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2020-08-14 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>AMYRIS, INC. [ AMRS ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Hager Barbara<br><sub>(Last) (First) (Middle)</sub><br>751 LAUREL STREET

#717<br><sub>(Street)</sub><br>SAN CARLOS, CA 94070<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2020-08-14 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>AMYRIS, INC. [ AMRS ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Vallejo Ventures Trust UTA 21296<br><sub>(Last) (First) (Middle)</sub><br>751 LAUREL STREET

#717<br><sub>(Street)</sub><br>SAN CARLOS, CA 94070<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2020-08-14 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>AMYRIS, INC. [ AMRS ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock | 2022-12-30 |  | A<sup>(1)</sup> |  | 13333334 | A | $1.50 | 87268358 | I | By Foris Ventures, LLC<sup>(2)(3)</sup> |
| Common Stock |  |  |  |  |  |  |  | 4531 | I | By KPCB XII Founders Fund, LLC<sup>(4)</sup> |
| Common Stock |  |  |  |  |  |  |  | 248304 | I | By Kleiner Perkins Caufield & Byers XII, LLC<sup>(5)</sup> |
| Common Stock |  |  |  |  |  |  |  | 3333333 | I | By Perrara Ventures, LLC<sup>(6)</sup> |
| Common Stock |  |  |  |  |  |  |  | 9648 | I | By Clarus, LLC<sup>(7)</sup> |
| Common Stock |  |  |  |  |  |  |  | 567 | I | By The Vallejo Ventures Trust U/T/A 2/12/96<sup>(8)</sup> |
| Common Stock |  |  |  |  |  |  |  | 106155 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 6% Convertible Note due 2023 | $3.00 | 2020-08-14 |  | P |  |  |  | <sup>(9)</sup> | 2023-07-01 | Common Stock |  | <sup>(9)</sup> |  | I | By Foris Ventures, LLC<sup>(2)(3)</sup> |
| Warrant (Right to Buy) | $1.80 | 2022-12-30 |  | A<sup>(1)</sup> |  | 10000000 |  | <sup>(10)</sup> | 2027-12-30 | Common Stock | 10000000 | <sup>(1)</sup> | 10000000 | I | By Foris Ventures, LLC<sup>(2)(3)</sup> |

---

### Footnotes:

(1) On December 29, 2022, the Issuer entered into a security purchase agreement with Foris Ventures, LLC ("FV"), pursuant to which the Issuer issued and sold to FV in a private placement (i) 13,333,334 shares of the  Issuer's common stock (the "Common Stock") and (ii) a warrant to purchase up to 10,000,000 shares of Common Stock, for an aggregate purchase price of $20,000,000.

(2) L. John Doerr ("John Doerr") indirectly holds all of the membership interests in FV. John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.

(3) Barbara Hager, the manager of FV, may be deemed to have sole power to vote and dispose of the shares held by FV. The Vallejo Ventures Trust U/T/A 2/12/96 ("VVT"), the member of FV, may be deemed to have sole power to vote and dispose of these securities and John Doerr and Ann Doerr, the trustees of VVT, and Barbara Hager, the special trustee of VVT, may be deemed to have shared power to vote and dispose of the reported securities. Each of John Doerr, Ann Doerr and Barbara Hager disclaims beneficial ownership of the reported securities except to the extent of their pecuniary interest therein. FV and VVT are represented on the Issuer's board of directors by John Doerr. Accordingly, each of the Reporting Persons is deemed to be a director by deputization. The Reporting Persons are jointly filing this Form 4 pursuant to Rule 16a-3(j) under the Exchange Act.

(4) The Managing Member of KPCB XII Founders Fund, LLC is KPCB XII Associates, LLC, of which John Doerr is the managing member. John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. The shares are held for convenience in the name of "KPCB Holdings, Inc., as nominee" for the account of entities affiliated with Kleiner Perkins Caufield & Byers and others. KPCB Holdings, Inc. has no voting, dispositive or pecuniary interest in any such shares.

(5) The Managing Member of Kleiner Perkins Caufield & Byers XII, LLC is KPCB XII Associates, LLC, of which John Doerr is the managing member. John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. The shares are held for convenience in the name of "KPCB Holdings, Inc., as nominee" for the account of entities affiliated with Kleiner Perkins Caufield & Byers and others. KPCB Holdings, Inc. has no voting, dispositive or pecuniary interest in any such shares.

(6) John Doerr indirectly holds all of the membership interests in Perrara Ventures, LLC. John Doerr disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.

(7) John Doerr and Ann Doerr are the trustees of VVT, which is the member of Clarus, LLC. Barbara Hager is the special trustee of VVT and manager of FV. By virtue of these relationships, John Doerr, Ann Doerr and Barbara Hager may be deemed to have the power to vote and dispose of shares held by Clarus, LLC. Each of John Doerr, Ann Doerr and Barbara Hager disclaims beneficial ownership of the shares held by Clarus, LLC except to the extent of their pecuniary interest therein, if any.

(8) John Doerr and Ann Doerr are the trustees of VVT. Barbara Hager is the special trustee of VVT and manager of FV. By virtue of these relationships, John Doerr, Ann Doerr and Barbara Hager may be deemed to have the power to vote and dispose of shares held by VVT. Each of John Doerr, Ann Doerr and Barbara Hager disclaims beneficial ownership of the shares held by VVT except to the extent of their pecuniary interest therein, if any.

(9) On October 28, 2019, the Issuer, FV, as lender, and the other parties thereto entered into that certain Amended and Restated Loan and Security Agreement (the "LSA"), pursuant to which the Issuer issued certain indebtedness to FV. On June 1, 2020, the parties to the LSA entered into Amendment No. 1 thereto, pursuant to which the Issuer granted FV the right to convert, at its option, all or any portion of the indebtedness outstanding under the LSA (the "2019 Convertible Note"), including accrued and unpaid interest, into shares of Common Stock, subject to stockholder approval, which was granted on August 14, 2020.  As of January 4, 2023, 16,680,334 shares of Common Stock are issuable upon conversion of the 2019 Convertible Note in respect of an outstanding principal amount of $50 million and 3,701,734  shares of Common Stock are issuable upon conversion of accrued and unpaid interest of $11.1 million, reflecting a fixed conversion price of $3.00 per share of Common Stock.

(10) The warrant is exercisable at a price of $1.80 per full share of Common Stock at any time after the date of issuance for a period of five years.

**Signature:** /s/ L. John Doerr, by Barbara Hager as his attorney in fact  
**Date:** 2023-01-04

**Signature:** /s/ Ann Howland Doerr, by Barbara Hager as her attorney in fact  
**Date:** 2023-01-04

**Signature:** /s/ Vallejo Ventures Trust UTA 21296, by Barbara Hager as Special Trustee  
**Date:** 2023-01-04

**Signature:** /s/ Foris Ventures, LLC, by Barbara Hager as manager  
**Date:** 2023-01-04

**Signature:** /s/ Barbara Hager  
**Date:** 2023-01-04

### Remarks:

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).

** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

**Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.**