0000950170-24-070082.txt : 20240606 0000950170-24-070082.hdr.sgml : 20240606 20240606190232 ACCESSION NUMBER: 0000950170-24-070082 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240605 FILED AS OF DATE: 20240606 DATE AS OF CHANGE: 20240606 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CORBETT JAMES CENTRAL INDEX KEY: 0001238620 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39059 FILM NUMBER: 241026816 MAIL ADDRESS: STREET 1: 2 GOODYEAR CITY: IRVINE STATE: CA ZIP: 92618 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AVITA Medical, Inc. CENTRAL INDEX KEY: 0001762303 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 202578762 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 28159 AVENUE STANFORD STREET 2: SUITE 220 CITY: VALENCIA STATE: CA ZIP: 91355 BUSINESS PHONE: 661-568-1317 MAIL ADDRESS: STREET 1: 28159 AVENUE STANFORD STREET 2: SUITE 220 CITY: VALENCIA STATE: CA ZIP: 91355 FORMER COMPANY: FORMER CONFORMED NAME: Avita Therapeutics, Inc. DATE OF NAME CHANGE: 20200630 FORMER COMPANY: FORMER CONFORMED NAME: Avita Medical, Ltd. DATE OF NAME CHANGE: 20181218 4 1 ownership.xml 4 X0508 4 2024-06-05 0001762303 AVITA Medical, Inc. RCEL 0001238620 CORBETT JAMES 28159 AVENUE STANFORD SUITE 220 - AVITA MEDICAL VALENCIA CA 91355 true true false false CEO false Stock Options (Right to Buy) 12.64 2024-06-05 4 A false 350000 0 A 2034-01-03 Common Stock 350000 350000 D Pursuant to Mr. Corbett's Employment Agreement, he is eligible for annual equity grants. On January 3, 2024, the Board of Directors approved a grant of 350,000 options to acquire 350,000 shares of Common Stock of the Company to Mr. Corbett, with an effective grant date of January 3, 2024 and an exercise price equal to the closing price of a share of Common Stock on Nasdaq on January 3, 2024 of $12.64. The grant was subject to the approval of the Company's stockholders, which was obtained on June 5, 2024. These Stock Options vest in three equal annual installments beginning on the date 12 months following the grant date of January 3, 2024. /s/ Donna Shiroma 2024-06-06