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