0001209191-22-013222.txt : 20220225 0001209191-22-013222.hdr.sgml : 20220225 20220225165423 ACCESSION NUMBER: 0001209191-22-013222 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220223 FILED AS OF DATE: 20220225 DATE AS OF CHANGE: 20220225 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: 22681366 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 Medical, 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: 661-568-1317 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 doc4.xml FORM 4 SUBMISSION X0306 4 2022-02-23 0 0001762303 AVITA Medical, Inc. RCEL 0001250379 PERRY MICHAEL S C/O AVITA MEDICAL, INC. 28159 AVENUE STANFORD, SUITE 220 VALENCIA CA 91355 1 1 0 0 Chief Executive Officer Common Stock 2022-02-23 4 A 0 23753 0.00 A 326564 D Common Stock 2022-02-23 4 A 0 5960 0.00 A 332524 D Common Stock 2022-02-24 4 S 0 10812 8.74 D 321712 D Stock Options (Right to Buy) 12.18 2022-02-23 4 A 0 3450 0.00 A 2022-02-23 2031-12-22 Common Stock 3450 3450 D These shares of Common Stock were issued upon the vesting of Restricted Stock Units ("RSUs"), which were originally granted on November 26, 2019, in connection with the satisfaction of a performance-based vesting condition. Includes unvested RSUs with vesting conditions based on the Reporting Person's continued employment or the market price of the Issuer's common stock. Includes 634,602 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 634,602 CDIs, which translate into 126,920 of the shares of Common Stock set forth above. These shares of Common Stock were issued upon the vesting of RSUs, which were originally granted on December 22, 2021, in connection with the satisfaction of a performance-based vesting condition. 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 $8.42 to $8.96. 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 granted on December 22, 2021 and vested on February 23, 2022 in connection with the satisfaction of a performance-based vesting condition. /s/ Donna Shiroma, by power of attorney 2022-02-25