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