0000903423-14-000174.txt : 20140326 0000903423-14-000174.hdr.sgml : 20140326 20140326182814 ACCESSION NUMBER: 0000903423-14-000174 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140326 FILED AS OF DATE: 20140326 DATE AS OF CHANGE: 20140326 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: APPLIED GENETIC TECHNOLOGIES CORP CENTRAL INDEX KEY: 0001273636 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 593553710 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 11801 RESEARCH DRIVE STREET 2: SUITE D CITY: ALACHUA STATE: FL ZIP: 32615 BUSINESS PHONE: 386-462-2204 MAIL ADDRESS: STREET 1: 11801 RESEARCH DRIVE STREET 2: SUITE D CITY: ALACHUA STATE: FL ZIP: 32615 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GLAXOSMITHKLINE PLC CENTRAL INDEX KEY: 0001131399 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36370 FILM NUMBER: 14719757 BUSINESS ADDRESS: STREET 1: 980 GREAT WEST ROAD CITY: BRENTFORD MIDDLESEX STATE: X0 ZIP: TW8 9GS BUSINESS PHONE: 011442080475000 MAIL ADDRESS: STREET 1: 980 GREAT WEST ROAD CITY: BRENTFORD MIDDLESEX STATE: X0 ZIP: TW8 9GS 3 1 gsk.xml OWNERSHIP DOCUMENT X0206 3 2014-03-26 0 0001273636 APPLIED GENETIC TECHNOLOGIES CORP AGTC 0001131399 GLAXOSMITHKLINE PLC 980 GREAT WEST ROAD BRENTFORD MIDDLESEX X0 TW8 9GS UNITED KINGDOM 0 0 1 0 Series B-1 Convertible Preferred Stock Common Stock 503579 I See Footnote Series B-2 Convertible Preferred Stock Common Stock 934487 I See Footnote Series B-3 Convertible Preferred Stock Common Stock 447770 I See Footnote Stock Option (Right to Buy) 12.00 2024-03-26 Common Stock 9375 I See Footnote Each share of convertible preferred stock is convertible into shares of common stock at any time at the holder's election or upon the consummation of a qualified public offering of the registrant on a 1-for-35 basis. The convertible preferred stock has no expiration date. Held of record by S.R. One Limited, an indirect, wholly-owned subsidiary of GlaxoSmithKline plc (the "Reporting Person"). The stock option becomes exercisable in equal yearly installments over three years from the date of grant, on March 26, 2014. The stock option was granted to Jill Carroll, a director of the Issuer. Ms. Carroll is a senior associate of S.R. One, Limited and an employee of GlaxoSmithKline LLC, a wholly-owned subsidiary of GlaxoSmithKline plc. As an associate of S.R. One, Limited and an employee of GlaxoSmithKline LLC, Ms. Carroll is obligated to transfer any shares issued under the option to S.R. One, Limited. /s/ Victoria Whyte, authorized representative 2014-03-26