0001209191-21-038189.txt : 20210604 0001209191-21-038189.hdr.sgml : 20210604 20210604160608 ACCESSION NUMBER: 0001209191-21-038189 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210602 FILED AS OF DATE: 20210604 DATE AS OF CHANGE: 20210604 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PERRY MICHAEL S CENTRAL INDEX KEY: 0001250379 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39059 FILM NUMBER: 21996487 MAIL ADDRESS: STREET 1: C/O BIOTRANSPLANT INC STREET 2: 196 BOSTON AVE SUITE 2800 CITY: MEDFORD STATE: MA ZIP: 02155 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AVITA Medical, Inc. CENTRAL INDEX KEY: 0001762303 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 202578762 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 28159 AVENUE STANFORD STREET 2: SUITE 220 CITY: VALENCIA STATE: CA ZIP: 91355 BUSINESS PHONE: 661-568-1317 MAIL ADDRESS: STREET 1: 28159 AVENUE STANFORD STREET 2: SUITE 220 CITY: VALENCIA STATE: CA ZIP: 91355 FORMER COMPANY: FORMER CONFORMED NAME: Avita Therapeutics, Inc. DATE OF NAME CHANGE: 20200630 FORMER COMPANY: FORMER CONFORMED NAME: Avita Medical, Ltd. DATE OF NAME CHANGE: 20181218 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-06-02 0 0001762303 AVITA Medical, Inc. RCEL 0001250379 PERRY MICHAEL S C/O AVITA MEDICAL, INC. 28159 AVENUE STANFORD, SUITE 220 VALENCIA CA 91355 1 1 0 0 Chief Executive Officer Common Stock 2021-06-02 4 S 0 23000 17.33 D 225104 D Represents shares sold in order to pay withholding taxes due in connection with the vesting of Restricted Stock Units ("RSUs"). The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $17.11 to $17.73. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of the shares of Common Stock sold at each separate price within the ranges set forth in this footnote to this Form 4. Includes 634,602 of the Issuer's CHESS Depositary Interests ("CDIs"). CDIs are units of beneficial ownership in shares of common stock of the Issuer that are publicly traded on the Australian Securities Exchange (the "ASX") and held by CHESS Depositary Nominees Pty, Limited, a subsidiary of ASX Limited, the company that operates the ASX. Five CDIs are equivalent to one share of Common Stock and have all the rights and privileges of Common Stock. The Reporting Person holds 634,602 CDIs, which translate into 126,920 of the shares of Common Stock set forth above. Includes 47,507 unvested RSUs, each representing a contingent right to be issued one share of Common Stock, that are subject to time-based vesting criteria. These RSUs were originally rights to receive ordinary shares of AVITA Medical, Ltd., an Australian public company and predecessor to the Issuer ("Predecessor"). Pursuant to a scheme of arrangement, completed on June 30, 2020, the RSUs became rights to be issued shares of Common Stock of the Issuer in the ratio of one share of Common Stock for every 100 ordinary shares of Predecessor to which the holder would otherwise have been entitled. The RSUs vest on June 1, 2022. 631,525 CDIs, which translate into 126,305 shares of Common Stock, and 50,677 shares of Common Stock were previously transferred to the Reporting Person's former spouse pursuant to a property settlement agreement entered into in connection with a divorce proceeding. The Reporting Person no longer reports as beneficially owned any securities owned by his former spouse. /s/ Donna Shiroma, by power of attorney 2021-06-04