0001209191-14-023235.txt : 20140326 0001209191-14-023235.hdr.sgml : 20140326 20140326173942 ACCESSION NUMBER: 0001209191-14-023235 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: Alta Partners Management VIII, LLC CENTRAL INDEX KEY: 0001399894 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36370 FILM NUMBER: 14719594 BUSINESS ADDRESS: STREET 1: ONE EMBARCADERO CENTER, SUITE 3700 CITY: SAN FRANCISCO STATE: CA ZIP: 94111 BUSINESS PHONE: 415-362-4022 MAIL ADDRESS: STREET 1: ONE EMBARCADERO CENTER, SUITE 3700 CITY: SAN FRANCISCO STATE: CA ZIP: 94111 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CHAMPSI FARAH CENTRAL INDEX KEY: 0001198321 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36370 FILM NUMBER: 14719595 MAIL ADDRESS: STREET 1: ONE EMBARCADERO CENTER SUITE 3700 CITY: SAN FRANCISCO STATE: CA ZIP: 94111 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JANNEY DANIEL CENTRAL INDEX KEY: 0001198325 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36370 FILM NUMBER: 14719596 MAIL ADDRESS: STREET 1: ONE EMBARCADERO CENTER SUITE 3700 CITY: SAN FRANCISCO STATE: CA ZIP: 94111 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NOHRA GUY P CENTRAL INDEX KEY: 0001198330 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36370 FILM NUMBER: 14719597 MAIL ADDRESS: STREET 1: ONE EMBARCADERO CENTER SUITE 3700 CITY: SAN FRANCISCO STATE: CA ZIP: 94111 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Alta Partners VIII, L.P. CENTRAL INDEX KEY: 0001399763 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36370 FILM NUMBER: 14719598 BUSINESS ADDRESS: STREET 1: ONE EMBARCADERO CENTER, SUITE 3700 CITY: SAN FRANCISCO STATE: CA ZIP: 94111 BUSINESS PHONE: 415-362-4022 MAIL ADDRESS: STREET 1: ONE EMBARCADERO CENTER, SUITE 3700 CITY: SAN FRANCISCO STATE: CA ZIP: 94111 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2014-03-26 0 0001273636 APPLIED GENETIC TECHNOLOGIES CORP AGTC 0001399763 Alta Partners VIII, L.P. ONE EMBARCADERO CENTER, 37TH FLOOR SAN FRANCISCO FL 94111 0 0 1 0 0001198330 NOHRA GUY P C/O ALTA PARTNERS ONE EMBARCADERO CENTER, 37TH FLOOR SAN FRANCISCO FL 94111 0 0 1 0 0001198325 JANNEY DANIEL C/O ALTA PARTNERS ONE EMBARCADERO CENTER, 37TH FLOOR SAN FRANCISCO FL 94111 0 0 1 0 0001198321 CHAMPSI FARAH C/O ALTA PARTNERS ONE EMBARCADERO CENTER, 37TH FLOOR SAN FRANCISCO FL 94111 0 0 1 0 0001399894 Alta Partners Management VIII, LLC ONE EMBARCADERO CENTER, 37TH FLOOR SAN FRANCISCO FL 94111 0 0 1 0 Series B-1 Convertible Preferred Stock Common Stock 755369 I Direct and indirect - see footnotes Series B-2 Convertible Preferred Stock Common Stock 1401731 I Direct and indirect - see footnotes Series B-3 Convertible Preferred Stock Common Stock 671655 I Direct and indirect - see footnotes 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. The securities are held of record by Alta Partners VIII, L.P. ("APVIII"). Alta Partners Management VIII, LLC ("APMVIII") is the general partner of APVIII. Guy Nohra, Daniel Janney and Farah Champsi are managing directors of APMVIII and exercise shared voting and investment power with respect to the shares onwed by APVIII. Each of the reporting persons disclaims beneficial ownership of such securities, except to the extent of his, her or its proportionate pecuniary interest therein. /s/ Laurence Randall 2014-03-26