Sec Form 4 Filing - Ericson William W. @ PACIFIC BIOSCIENCES OF CALIFORNIA, INC. - 2021-02-12

Insider filing report for Changes in Beneficial Ownership
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FORM 4
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
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
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1. Name and Address of Reporting Person
Ericson William W.
2. Issuer Name and Ticker or Trading Symbol
PACIFIC BIOSCIENCES OF CALIFORNIA, INC. [ PACB]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
PACIFIC BIOSCIENCES OF CALIFORNIA, INC., 1305 O'BRIEN DRIVE
3. Date of Earliest Transaction (MM/DD/YY)
02/12/2021
(Street)
MENLO PARK, CA94025
4. If Amendment, Date Original Filed (MM/DD/YY)
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 Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction 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 02/12/2021 J( 1 ) 750,000 D 4,848,397( 2 ) I MDV VII LP, nom for MDV VII LP, MDV VII Leaders' Fund LP, MDV ENF VII (A) LP, and MDV ENF VII (B) LP( 3 )
Common Stock 02/12/2021 J( 1 ) 68 A 68 D( 4 )
Common Stock 03/17/2022 J( 5 ) 4,848,397 D 0 I MDV VII LP, nom for MDV VII LP, MDV VII Leaders' Fund LP, MDV ENF VII (A) LP, and MDV ENF VII (B) LP( 3 )
Common Stock 03/17/2022 J( 5 ) 1,268 A 1,336 D( 6 )
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Benef icially 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
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Ericson William W.
PACIFIC BIOSCIENCES OF CALIFORNIA, INC.
1305 O'BRIEN DRIVE
MENLO PARK, CA94025
X
Signatures
/s/ Brett Atkins, Attorney-in-fact 04/13/2022
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Distribution in kind from MDV VII Leaders' Fund, L.P. and MDV VII, L.P. without consideration to their partners.
( 2 )These shares were inadvertently omitted as a holding on a Form 4 filed on June 21, 2021.
( 3 )Seventh MDV Partners, L.L.C. is the general partner of (i) MDV VII, L.P., as nominee for MDV VII, L.P., MDV VII Leaders' Fund, L.P., MDV ENF VII(A), L.P, and MDV ENF VII(B), L.P., (ii) MDV VII, L.P., (iii) MDV ENF VII(A), L.P., (iv) MDV ENF VII(B), L.P. and (v) MDV VII Leaders' Fund, L.P. (the "MDV VII Funds") and has sole voting and investment power over the shares. William Ericson is a Managing director with Mohr Davidow Ventures, but is not a Managing Member of Seventh MDV Partners, LLC, however he may be deemed to indirectly beneficially own the shares affiliated with the MDV VII Funds. Mr. Ericson disclaims beneficial ownership of the shares held by the MDV VII Funds except to the extent of any pecuniary interest therein.
( 4 )Shares are directly held by William Ericson, and were received pursuant to the in-kind distribution without consideration by MDV VII Leaders' Fund, L.P. and MDV VII, L.P. to their partners.
( 5 )Distribution in kind from MDV VII Leaders' Fund, L.P., MDV VII, L.P., MDV ENF VII(A), L.P, and MDV ENF VII(B), L.P., without consideration to their partners.
( 6 )Shares are directly held by William Ericson, and were received pursuant to the in-kind distribution without consideration by MDV VII Leaders' Fund, L.P. to its partners.

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