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