Edgar Filing: Kaul Samir

Ownership Submission

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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(h) of the Investment Company Act of 1940

OMB APPROVAL

OMB Number:

3235-0104

Expires:

January 31, 2005

Estimated average burden hours per response...

0.5

(Print or Type Responses)

1. Name and Address of Reporting Person ^*

Â Kaul Samir

2. Date of Event Requiring Statement (Month/Day/Year)
09/27/2010

3. Issuer Name and Ticker or Trading Symbol
AMYRIS, INC. [AMRS]

(Last)

(First)

(Middle)

3000 SAND HILL ROAD,Â BUILDING 3, SUITE 190

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

__X__ Director	__X__ 10% Owner
_____ Officer (give title below)	_____ Other (specify below)

5. If Amendment, Date Original Filed(Month/Day/Year)

(Street)

MENLO PARK,Â CAÂ 94025

6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

(City)

(State)

(Zip)

Table I - Non-Derivative Securities Beneficially Owned

1.Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock	145,166	I	See footnote ⁽¹⁾ ⁽²⁾

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.			SEC 1473 (7-02)
	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.

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security		6. Nature of Indirect Beneficial Ownership (Instr. 5)
Series A Convertible Preferred Stock	Â ⁽³⁾	Â ⁽³⁾	Common Stock	3,179,674 ⁽³⁾	$ ⁽³⁾	I	See footnote ⁽²⁾ ⁽⁴⁾
Series B Convertible Preferred Stock	Â ⁽⁵⁾	Â ⁽⁵⁾	Common Stock	138,919 ⁽⁵⁾	$ ⁽⁵⁾	I	See footnote ⁽²⁾ ⁽⁴⁾
Series C Convertible Preferred Stock	Â ⁽³⁾	Â ⁽³⁾	Common Stock	419,687 ⁽³⁾	$ ⁽³⁾	I	See footnote ⁽¹⁾ ⁽²⁾
Series A Convertible Preferred Stock	Â ⁽³⁾	Â ⁽³⁾	Common Stock	154,765 ⁽³⁾	$ ⁽³⁾	I	See footnote ⁽⁶⁾
Series B Convertible Preferred Stock	Â ⁽⁵⁾	Â ⁽⁵⁾	Common Stock	6,761 ⁽⁵⁾	$ ⁽⁵⁾	I	See footnote ⁽⁶⁾

Reporting Owners

Reporting Owner Name / Address	Relationships
Reporting Owner Name / Address	Director	10% Owner	Officer	Other
Kaul Samir 3000 SAND HILL ROAD BUILDING 3, SUITE 190 MENLO PARK,Â CAÂ 94025	Â X	Â X	Â	Â

Signatures

/s/ Samir Kaul by Tamara Tompkins, Attorney-in-Fact		09/27/2010
^**Signature of Reporting Person		Date

Explanation of Responses:

*	If the form is filed by more than one reporting person, see Instruction 5(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).
(1)	The securities are owned by Khosla Ventures III, L.P. ("Khosla III"). Khosla Ventures Associates III, LLC ("KVA III") is the general partner of Khosla III and possesses sole voting and investment control over the shares owned by Khosla III and may be deemed to have indirect beneficial ownership of the shares held by Khosla III. KVA III however owns no securities of the Issuer directly. KVA III disclaims beneficial ownership of such shares except to the extent of its pecuniary interest therein.
(2)	Mr. Kaul is a member of Khosla Ventures Associates II, LLC ("KVA II"), the general partner of Khosla Ventures II, L.P. ("Khosla II"), and a member of KVA III. As such, Mr. Kaul shares voting and investment power over the shares held by Khosla II and Khosla III and may be deemed to have indirect beneficial ownership of the shares held by Khosla II and Khosla III. Mr. Kaul disclaims beneficial ownership of these securities except to the extent of his proportionate pecuniary interest therein.
(3)	Upon the closing of the Issuer's initial public offering, each outstanding share of Series A Preferred Stock and Series C Preferred Stock will be 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.
(4)	The securities are owned by Khosla II. KVA II possesses sole voting and investment control over the shares owned by Khosla II and may be deemed to have indirect beneficial ownership of the shares held by Khosla II. KVA II however owns no securities of the Issuer directly. KVA II disclaims beneficial ownership of such shares except to the extent of its pecuniary interest therein.
(5)	Upon completion of the Issuer's initial public offering, each outstanding share of Series B Preferred Stock will be automatically converted into 1.118 shares of the Issuer's Common Stock. The number of shares of underlying Common Stock reported in Column 3 does not reflect this automatic conversion. The Series B Preferred Stock has no expiration date.
(6)	The securities are held by the Kaul Family Revocable Trust. Mr. Kaul is a trustee of the Kaul Family Revocable Trust.
Â Remarks: ExhibitÂ ListÂ ------------------Â ExhibitÂ 24Â -Â PowerÂ ofÂ Attorney

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

Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.