Wen HSIEH - Sep 14, 2022 Form 3 Insider Report for Amprius Technologies, Inc. (AMPX)

Role
Director
Signature
/s/ Sandra Wallach, attorney-in-fact on behalf of Wen Hsieh
Stock symbol
AMPX
Transactions as of
Sep 14, 2022
Transactions value $
$0
Form type
3
Date filed
9/16/2022, 06:50 PM
Previous filing
Jun 10, 2022
Next filing
Feb 13, 2023

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
holding AMPX Common Stock 100K Sep 14, 2022 See Footnotes F1, F2

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
holding AMPX Warrants (right to buy) Sep 14, 2022 Common Stock 100K $12.50 See Footnotes F2, F3, F4
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Consists of (i) 92,200 shares beneficially owned by Kleiner Perkins Caufield & Byers XIV, LLC ("KPCB XIV") and (ii) 7,800 shares beneficially owned by KPCB XIV Founders Fund, LLC ("KPCB XIV Founders"). All securities are held for convenience in the name of "KPCB Holdings, Inc., as nominee" for the accounts of such entities.
F2 The managing member of KPCB XIV and KPCB XIV Founders is KPCB XIV Associates, LLC ("KPCB XIV Associates"). L. John Doerr, Brook Byers, William "Bing" Gordon and Theodore E. Schlein, the managing members of KPCB XIV Associates, exercise shared voting and dispositive control over the shares held by KPCB XIV and KPCB XIV Founders. The Reporting Person disclaims beneficial ownership of the securities except to the extent of any pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose.
F3 The securities become exercisable on October 14, 2022, provided that in no event are the securities exercisable unless a registration statement registering the shares issuable on exercise thereof has been declared effective.
F4 Consists of (i) 92,200 warrants beneficially owned by KPCB XIV and (ii) 7,800 warrants beneficially owned by KPCB XIV Founders. All securities are held for convenience in the name of "KPCB Holdings, Inc., as nominee" for the accounts of such individuals and entities.

Remarks:

Exhibit 24 - Power of Attorney