0001209191-14-024141.txt : 20140401
0001209191-14-024141.hdr.sgml : 20140401
20140401163115
ACCESSION NUMBER: 0001209191-14-024141
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
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: Rosen James
CENTRAL INDEX KEY: 0001602725
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36370
FILM NUMBER: 14734623
MAIL ADDRESS:
STREET 1: C/O APPLIED GENETIC TECHNOLOGIES CORP.
CITY: ALACHUA
STATE: FL
ZIP: 02210
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2014-04-01
0
0001273636
APPLIED GENETIC TECHNOLOGIES CORP
AGTC
0001602725
Rosen James
C/O APPLIED GENETIC TECHNOLOGIES CORP
11801 RESEARCH DRIVE, SUITE D
ALACHUA
FL
32615
1
0
1
0
Common Stock
2014-04-01
4
C
0
1142666
A
1142666
I
See footnotes
Common Stock
2014-04-01
4
P
0
62871
12.00
A
1205537
I
See footnotes
Series A-1 Convertible Preferred Stock
2014-04-01
4
C
0
10443612
0.00
D
Common Stock
628399
0
I
See footnotes
Series B-1 Convertible Preferred Stock
2014-04-01
4
C
0
4806416
0.00
D
Common Stock
137326
0
I
See footnotes
Series B-2 Convertible Preferred Stock
2014-04-01
4
C
0
8919218
0.00
D
Common Stock
254834
0
I
See footnotes
Series B-3 Convertible Preferred Stock
2014-04-01
4
C
0
4273746
0.00
D
Common Stock
122107
0
I
See footnotes
Series B-1 Warrant (Right to Buy)
0.1297
2014-04-01
4
C
0
312228
0.00
D
2017-05-02
Series B-1 Convertible Preferred Stock
312228
0
I
See footnotes
Common Stock Warrant (Right to Buy)
4.54
2014-04-01
4
C
0
8920
0.00
A
2017-05-02
Common Stock
8920
8920
I
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.
Shares are held of record by Intersouth Partners VI, L.P. Intersouth Associates VI, LLC is the general partner of Intersouth Partners VI, L.P. The reporting person is a partner at Intersouth Associates VI, LLC. The reporting person disclaims beneficial ownership of all the shares held by Intersouth Partners VI, L.P. and this report shall not be deemed an admission of beneficial ownership of such shares for the purposes of Section 16 or for any other purpose except to the extent of his 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.
Each share of Series B-1 convertible preferred stock automatically converted into shares of common stock upon the closing of the Issuer's initial public offering on a 1-for-35 basis.
Warrant was fully exercisable upon original issue.
/s/ Hemmie Chang, attorney-in-fact for James Rosen
2014-04-01
EX-24.4_516415
2
poa.txt
POA DOCUMENT
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS, that the undersigned hereby authorizes Hemmie Chang
and Robert W. Sweet, Jr., each of Foley Hoag LLP, to execute for and on behalf
of the undersigned, in the undersigned's capacity as a director of Applied
Genetic Technologies Corporation (the "Company"), a Form ID, Forms 3, 4 and 5,
and any amendments thereto, and cause such form(s) to be filed with the United
States Securities and Exchange Commission pursuant to Section 16(a) of the
Securities Act of 1934, relating to the undersigned's beneficial ownership of
securities in the Company. The undersigned hereby grants to the attorney-in-fact
full power and authority to do and perform any and every act and thing
whatsoever requisite, necessary or proper to be done in the exercise of any of
the rights and powers herein granted, as fully to all intents and purposes as
the undersigned might or could do personally present, with full power of
substitution, resubstitution or revocation, hereby ratifying and confirming all
that such attorney-in-fact, or such attorney's-in-fact substitute or
substitutes, shall lawfully do or cause to be done by virtue of this power of
attorney and the rights and powers herein granted. The undersigned acknowledges
that the foregoing attorney-in-fact, in serving in such capacity at the request
of the undersigned, is not assuming, nor is the Company assuming, any of the
undersigned's responsibilities to comply with Section 16 of the Securities
Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4 and 5 with respect to the
undersigned's holdings of, and transactions in, securities issued by the
Company, unless earlier revoked by the undersigned in a signed writing delivered
to the foregoing attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 12th day of January, 2014.
/s/ James Rosen
James Rosen