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