0001209191-23-004661.txt : 20230124
0001209191-23-004661.hdr.sgml : 20230124
20230124175052
ACCESSION NUMBER: 0001209191-23-004661
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230119
FILED AS OF DATE: 20230124
DATE AS OF CHANGE: 20230124
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ekins Sean
CENTRAL INDEX KEY: 0001833454
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39059
FILM NUMBER: 23549221
MAIL ADDRESS:
STREET 1: C/O AVITA MEDICAL
STREET 2: 28159 AVENUE STANFORD, SUITE 220
CITY: VALENCIA
STATE: CA
ZIP: 91355
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: 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
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2023-01-19
0
0001762303
AVITA Medical, Inc.
RCEL
0001833454
Ekins Sean
C/O AVITA MEDICAL, INC.
28159 AVENUE STANFORD, SUITE 220
VALENCIA
CA
91355
0
1
0
0
Interim CFO
Common Stock
14927
D
Stock Options (Right to Buy)
4.26
2028-06-12
Common Stock
9000
D
Stock Options (Right to Buy)
4.26
2028-06-12
Common Stock
5000
D
Stock Options (Right to Buy)
6.38
2028-11-01
Common Stock
5000
D
Stock Options (Right to Buy)
39.58
2029-10-01
Common Stock
5000
D
Stock Options (Right to Buy)
21.93
2031-03-17
Common Stock
30000
D
Stock Options (Right to Buy)
20.21
2031-07-06
Common Stock
2300
D
Stock Options (Right to Buy)
18.21
2031-08-26
Common Stock
1650
D
Stock Options (Right to Buy)
4.97
2032-07-01
Common Stock
7050
D
Includes unvested Restricted Stock Units, each representing a contingent right to be issued one share of Common Stock.
These Stock Options were originally exercisable for ordinary shares of Avita Medical, Ltd. ("Predecessor"). Pursuant to a scheme of arrangement, completed on June 30, 2020, the Stock Options became exercisable for shares of Common Stock of the Issuer in the ratio of one share of Common Stock for every 100 ordinary shares of Predecessor for which the Stock Options would otherwise be exercisable.
These Stock Options became exercisable upon the satisfaction of time-based and performance-based vesting criteria.
The exercise price was converted from A$0.056, which reflects the 100:1 consolidation ratio applied in converting ordinary shares of Predecessor to shares of the Issuer's Common Stock, using the exchange rate as in effect on the date of grant (June 12, 2018).
These Stock Options become exercisable in four equal annual installments beginning on June 12, 2019.
These Stock Options become exercisable in four equal annual installments beginning on November 1, 2019.
The exercise price was converted from A$0.089, which reflects the 100:1 consolidation ratio applied in converting ordinary shares of Predecessor to shares of the Issuer's Common Stock, using the exchange rate as in effect on the date of grant (November 1, 2018).
These Stock Options become exercisable in four equal annual installments beginning on October 1, 2020.
The exercise price was converted from A$0.590, which reflects the 100:1 consolidation ratio applied in converting ordinary shares of Predecessor to shares of the Issuer's Common Stock, using the exchange rate as in effect on the date of grant (October 1, 2019).
These Stock Options become exercisable in four equal annual installments beginning on March 17, 2022.
These Stock Options become exercisable in four equal annual installments beginning on July 6, 2022.
These Stock Options become exercisable in four equal annual installments beginning on August 26, 2022.
These Stock Options become exercisable in three equal annual installments beginning on August 20, 2023.
/s/ Donna Shiroma, by power of attorney
2023-01-24