Amyris
AMYRIS, INC. (Form: 4, Received: 09/30/2010 19:28:20)
FORM 4
[ X ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).         
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
                                                                                  
OMB APPROVAL
OMB Number: 3235-0287
Expires: February 28, 2011
Estimated average burden
hours per response...
0.5
                      
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public
Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

KPCB XII Associates, LLC
2. Issuer Name and Ticker or Trading Symbol

AMYRIS, INC. [ AMRS ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

_____ Director                      __ X __ 10% Owner
_____ Officer (give title below)      _____ Other (specify below)
(Last)          (First)          (Middle)

2750 SAND HILL ROAD
3. Date of Earliest Transaction (MM/DD/YYYY)

9/30/2010
(Street)

MENLO PARK, CA 94025
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
6. Individual or Joint/Group Filing (Check Applicable Line)

_ X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock   9/30/2010     C    3068996   (1) A $0   (1) 3198949   I   See Footnote   (2)
Common Stock   9/30/2010     C    149904   (3) A $0   (3) 3348853   I   See Footnote   (2)
Common Stock   9/30/2010     C    375705   (1) A $0   (1) 3724558   I   See Footnote   (2)
Common Stock   9/30/2010     C    58648   (1) A $0   (1) 60303   I   See Footnote   (4)
Common Stock   9/30/2010     C    2865   (3) A $0   (3) 63168   I   See Footnote   (4)
Common Stock   9/30/2010     C    4784   (1) A $0   (1) 67952   I   See Footnote   (4)

Table II - Derivative Securities Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Trans. Date 3A. Deemed Execution Date, if any 4. Trans. Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
6. Date Exercisable and Expiration Date 7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Series A Preferred Stock   $0   (1) 9/30/2010     C         3068996   (1)     (1)   (1) Common Stock   3068996   (1) $0   0   I   See Footnote   (2)
Series A Preferred Stock   $0   (1) 9/30/2010     C         58648   (1)     (1)   (1) Common Stock   58648   (1) $0   0   I   See Footnote   (4)
Series B Preferred Stock   $0   (3) 9/30/2010     C         134082   (3)     (3)   (3) Common Stock   149904   (3) $0   0   I   See Footnote   (2)
Series B Preferred Stock   $0   (3) 9/30/2010     C         2563   (3)     (3)   (3) Common Stock   2865   (3) $0   0   I   See Footnote   (4)
Series C Preferred Stock   $0   (1) 9/30/2010     C         375705   (1)     (1)   (1) Common Stock   375705   (1) $0   0   I   See Footnote   (2)
Series C Preferred Stock   $0   (1) 9/30/2010     C         4784   (1)     (1)   (1) Common Stock   4784   (1) $0   0   I   See Footnote   (4)

Explanation of Responses:
( 1)  Upon completion of the Issuer's initial public offering, each outstanding share of Series A Preferred Stock and Series C Preferred Stock automatically converted into one share of the Issuer's Common Stock. The Series A Preferred Stock and Series C Preferred Stock have no expiration date.
( 2)  Shares are held directly by Kleiner Perkins Caufield & Byers XII, LLC of which the Reporting Person is the Managing Member. The Reporting Person disclaims beneficial ownership of these securities except to the extent of its 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.
( 3)  Upon completion of the Issuer's initial public offering, each outstanding share of Series B Preferred Stock automatically converted into 1.118 shares of the Issuer's Common Stock. The Series B Preferred Stock has no expiration date.
( 4)  Shares are held directly by KPCB XII Founders Fund, LLC of which the Reporting Person is the Managing Member. The Reporting Person disclaims beneficial ownership of these securities except to the extent of its 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.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director 10% Owner Officer Other
KPCB XII Associates, LLC
2750 SAND HILL ROAD
MENLO PARK, CA 94025

X


Signatures
/s/ Theodore E. Schlein, Manager of the Reporting Person 9/30/2010
** Signature of Reporting Person Date


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 control number.