0001209191-14-024134.txt : 20140401
0001209191-14-024134.hdr.sgml : 20140401
20140401162832
ACCESSION NUMBER: 0001209191-14-024134
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140401
FILED AS OF DATE: 20140401
DATE AS OF CHANGE: 20140401
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: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36370
FILM NUMBER: 14734572
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: NOHRA GUY P
CENTRAL INDEX KEY: 0001198330
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36370
FILM NUMBER: 14734573
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: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36370
FILM NUMBER: 14734574
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: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36370
FILM NUMBER: 14734575
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: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36370
FILM NUMBER: 14734576
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2014-04-01
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
0001198321
CHAMPSI FARAH
ONE EMBARCADERO CENTER, 37TH FLOOR
SAN FRANCISCO
FL
94111
0
0
1
0
0001198325
JANNEY DANIEL
ONE EMBARCADERO CENTER, 37TH FLOOR
SAN FRANCISCO
FL
94111
0
0
1
0
0001198330
NOHRA GUY P
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
Common Stock
2014-04-01
4
C
0
2828755
A
2828755
I
Direct and indirect - see footnotes
Common Stock
2014-04-01
4
P
0
155645
12.00
A
2984400
I
Direct and indirect - see footnotes
Series B-1 Convertible Preferred Stock
2014-04-01
4
C
0
26437934
0.00
D
Common Stock
755369
0
I
Direct and indirect - see footnotes
Series B-2 Convertible Preferred Stock
2014-04-01
4
C
0
49060606
0.00
D
Common Stock
1401731
0
I
Direct and indirect - see footnotes
Series B-3 Convertible Preferred Stock
2014-04-01
4
C
0
23507953
0.00
D
Common Stock
671655
0
I
Direct and indirect - see footnotes
Each share of convertible preferred stock converted automatically into common stock upon the closing of the Issuer's initial public offering, and had 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 owned 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.
Shares purchased in the Issuer's initial public offering at the initial public offering price of $12.00 per share.
Not applicable.
/s/ Laurence Randall
2014-04-01
Farah Champsi
2014-04-01
Daniel Janney
2014-04-01
Guy Nohra
2014-04-01
Laurence Randall
2014-04-01