0000950170-24-002565.txt : 20240105 0000950170-24-002565.hdr.sgml : 20240105 20240105174933 ACCESSION NUMBER: 0000950170-24-002565 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240103 FILED AS OF DATE: 20240105 DATE AS OF CHANGE: 20240105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: O'Toole David D CENTRAL INDEX KEY: 0001491140 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39059 FILM NUMBER: 24517700 MAIL ADDRESS: STREET 1: 1640 MARENGO STREET CITY: LOS ANGELES STATE: CA ZIP: 90033 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AVITA Medical, Inc. CENTRAL INDEX KEY: 0001762303 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 202578762 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 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 ownership.xml 4 X0508 4 2024-01-03 0001762303 AVITA Medical, Inc. RCEL 0001491140 O'Toole David D 28159 AVENUE STANFORD SUITE 220 - AVITA MEDICAL VALENCIA CA 91355 false true false false CFO false Stock Options (Right to Buy) 12.64 2024-01-03 4 A false 125000 0 A 2033-01-03 Common Stock 125000 125000 D These Stock Options vest in three equal annual installments beginning with the first anniversary of the grant date. /s/ Donna Shiroma 2024-01-05