0001209191-20-050215.txt : 20200911 0001209191-20-050215.hdr.sgml : 20200911 20200911195907 ACCESSION NUMBER: 0001209191-20-050215 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200909 FILED AS OF DATE: 20200911 DATE AS OF CHANGE: 20200911 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PERRY MICHAEL S CENTRAL INDEX KEY: 0001250379 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39059 FILM NUMBER: 201171993 MAIL ADDRESS: STREET 1: C/O BIOTRANSPLANT INC STREET 2: 196 BOSTON AVE SUITE 2800 CITY: MEDFORD STATE: MA ZIP: 02155 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Avita Therapeutics, Inc. CENTRAL INDEX KEY: 0001762303 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 202578762 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 28159 AVENUE STANFORD STREET 2: SUITE 220 CITY: VALENCIA STATE: CA ZIP: 91355 BUSINESS PHONE: 661-367-9170 MAIL ADDRESS: STREET 1: 28159 AVENUE STANFORD STREET 2: SUITE 220 CITY: VALENCIA STATE: CA ZIP: 91355 FORMER COMPANY: FORMER CONFORMED NAME: Avita Medical, Ltd. DATE OF NAME CHANGE: 20181218 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-09-09 0 0001762303 Avita Therapeutics, Inc. RCEL 0001250379 PERRY MICHAEL S C/O AVITA THERAPEUTICS, INC. 28159 AVENUE STANFORD, SUITE 220 VALENCIA CA 91355 1 1 0 0 Chief Executive Officer Common Stock 2020-09-09 4 A 0 83333 0.00 A 431572 D Common Stock 2020-09-10 4 S 0 7128 26.26 D 424444 D Common Stock 2020-09-11 4 S 0 20000 26.02 D 404444 D Stock Options (Right to Buy) 5.99 2020-09-09 4 A 0 25000 0.00 A 2020-09-09 2028-11-30 Common Stock 25000 150000 D These shares of Common Stock were issued in connection with the vesting of Restricted Stock Units ("RSUs"), which were originally granted on November 30, 2018, upon the satisfaction of a performance-based vesting condition. Includes 1,266,125 of the Issuer's CHESS Depositary Interests ("CDIs"). CDIs are units of beneficial ownership in shares of common stock of the Issuer that are publicly traded on the Australian Securities Exchange (the "ASX") and held by CHESS Depositary Nominees Pty, Limited, a subsidiary of ASX Limited, the company that operates the ASX. Five CDIs are equivalent to one share of Common Stock and have all the rights and privileges of Common Stock. The Reporting Person holds 1,266,125 CDIs, which translate into 253,225 of the shares of Common Stock set forth above. Includes 95,014 unvested RSUs, each representing a contingent right to be issued one share of Common Stock, that are subject to time-based vesting criteria. These RSUs were originally rights to receive ordinary shares of AVITA Medical, Ltd., an Australian public company and predecessor to the Issuer ("Predecessor"). Pursuant to a scheme of arrangement, completed on June 30, 2020 (the "Scheme"), the RSUs became rights to be issued shares of Common Stock of the Issuer in the ratio of one share of Common Stock for every 100 ordinary shares of Predecessor to which the holder would otherwise have been entitled. The RSUs vest in two equal installments on June 1, 2021 and 2022. Represents shares sold in order to pay withholding taxes due in connection with the vesting of RSUs. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $26.00 to $26.53. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of the shares of Common Stock sold at each separate price within the ranges set forth in this footnote to this Form 4. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $25.77 to $26.26. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of the shares of Common Stock sold at each separate price within the ranges set forth in this footnote to this Form 4. These Stock Options were originally exercisable for ordinary shares of Predecessor. Pursuant to the Scheme, the Stock Options became exercisable for shares of Common Stock of the Issuer in the ratio of one share of Common Stock for every 100 ordinary shares of Predecessor for which the Stock Options would otherwise have been exercisable. The exercise price was converted from A$8.20, which reflects the 100:1 consolidation ratio applied in converting ordinary shares of Predecessor to shares of the Issuer's Common Stock, using the exchange rate as published by the Reserve Bank of Australia in effect on the date of grant (November 30, 2018). The actual exercise price will be the Australian dollar amount regardless of the exchange rate on the date of grant or of exercise. On November 30, 2018, the Reporting Person was granted Stock Options to purchase 150,000 shares of Common Stock, vesting based on the satisfaction of certain time-based and performance-based conditions. On September 9, 2020, the performance-based vesting condition with respect to the last 25,000 unvested Stock Options was satisfied. /s/ Donna Shiroma, by power of attorney 2020-09-11