SEC Form 3

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 or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person* Roth Ambra R. (Last) (First) (Middle) C/O MACOM TECHNOLOGY SOLUTIONS HOLDINGS 100 CHELMSFORD STREET (Street) LOWELL MA 01851 (City) (State) (Zip)	2. Date of Event Requiring Statement (Month/Day/Year) 10/29/2019	3. Issuer Name and Ticker or Trading Symbol MACOM Technology Solutions Holdings, Inc. [ MTSI ]
		4. Relationship of Reporting Person(s) to Issuer (Check all applicable) Director 10% Owner X Officer (give title below) Other (specify below) SVP, GC, HR & Secretary	5. If Amendment, Date of Original Filed (Month/Day/Year)
			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 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	17,093(1)	D

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: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
	Date Exercisable	Expiration Date	Title	Amount or Number of Shares
Stock Option (Right to Buy)	(2)	02/12/2020	Common Stock	322	19.45	D

Explanation of Responses:

1. Includes (i) 5,055 restricted stock units ("RSUs") granted on November 6, 2018, which vest as follows: 1,263 RSUs vest on May 15, 2020, 1,263 RSUs vest on May 15, 2021, 1,263 RSUs vest on May 15, 2022 and 1,266 RSUs vest on May 15, 2023; (ii) 1,839 RSUs granted on March 15, 2018, which vest as follows: 613 RSUs vest on February 15, 2020, 613 RSUs vest on February 15, 2021 and 613 RSUs vest on February 15, 2022; (iii) 953 RSUs granted on March 14, 2017, which vest as follows: 476 RSUs vest on February 15, 2020 and 477 RSUs vest on February 15, 2021; and (iv) 558 RSUs granted on March 17, 2016, which vest on February 15, 2020, provided with respect to each vesting event described herein that the Reporting Person remains in continuous service with the Issuer through such vesting date. All RSUs were granted to the Reporting Person under the Issuer's 2012 Omnibus Incentive Plan and each RSU represents the contingent right to receive one share of Common Stock.

2. The Stock Option vested in full on December 19, 2013.

Remarks:

	/s/ Ambra R. Roth	10/31/2019
	** 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 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).
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