0001140361-15-001931.txt : 20150115
0001140361-15-001931.hdr.sgml : 20150115
20150115165802
ACCESSION NUMBER: 0001140361-15-001931
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150113
FILED AS OF DATE: 20150115
DATE AS OF CHANGE: 20150115
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Avalanche Biotechnologies, Inc.
CENTRAL INDEX KEY: 0001501756
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 205258327
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1035 O?BRIEN DRIVE, SUITE A
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-272-6269
MAIL ADDRESS:
STREET 1: 1035 O?BRIEN DRIVE, SUITE A
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Chalberg Thomas W.
CENTRAL INDEX KEY: 0001614872
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36579
FILM NUMBER: 15530469
MAIL ADDRESS:
STREET 1: C/O AVALANCHE BIOTECHNOLOGIES, INC.
STREET 2: 1035 O'BRIEN DRIVE, SUITE A
CITY: MENLO PARK
STATE: CA
ZIP: 94025
4
1
doc1.xml
FORM 4
X0306
4
2015-01-13
0
0001501756
Avalanche Biotechnologies, Inc.
AAVL
0001614872
Chalberg Thomas W.
C/O AVALANCHE BIOTECHNOLOGIES, INC.
1035 O'BRIEN DRIVE, SUITE A
MENLO PARK
CA
94025
1
1
0
0
Chief Executive Officer
Common Stock
2015-01-13
4
S
0
85000
55.46
D
285988
D
Common Stock
420000
I
See Footnote
Common Stock
420000
I
See Footnote
Common Stock
413
I
See Footnote
The shares are held directly by Thomas W. Chalberg, as Trustee of the Thomas W. Chalberg 2014 Grantor Retained Annuity Trust under agreement dated April 30, 2014.
The shares are held directly by the Stefanie R. Chalberg 2014 Grantor Retained Annuity Trust under agreement Dated April 30, 2014.
The shares are held directly by the 2009 Chalberg Family Trust, Thomas W. Chalberg, Jr. and Stefanie Raue Chalberg, Trustees
/s/ Michael C. Swartzburg, Attorney-in-Fact for Thomas W. Chalberg
2015-01-15