0001104659-16-121886.txt : 20160518 0001104659-16-121886.hdr.sgml : 20160518 20160518165204 ACCESSION NUMBER: 0001104659-16-121886 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160511 FILED AS OF DATE: 20160518 DATE AS OF CHANGE: 20160518 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Adverum Biotechnologies, Inc. CENTRAL INDEX KEY: 0001501756 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 205258327 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1035 O'BRIEN DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-272-6269 MAIL ADDRESS: STREET 1: 1035 O'BRIEN DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 FORMER COMPANY: FORMER CONFORMED NAME: Avalanche Biotechnologies, Inc. DATE OF NAME CHANGE: 20100921 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Versant Capital IV (Switzerland) GmbH CENTRAL INDEX KEY: 0001674481 STATE OF INCORPORATION: V8 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36579 FILM NUMBER: 161661027 BUSINESS ADDRESS: STREET 1: AESCHENVORSTADT 36 CITY: BASEL STATE: V8 ZIP: 4051 BUSINESS PHONE: (415) 801-8100 MAIL ADDRESS: STREET 1: AESCHENVORSTADT 36 CITY: BASEL STATE: V8 ZIP: 4051 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Versant IV Luxco S.a r.l. CENTRAL INDEX KEY: 0001674642 STATE OF INCORPORATION: N4 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36579 FILM NUMBER: 161661028 BUSINESS ADDRESS: STREET 1: 5, RUE GUILLAUME KROLL CITY: LUXEMBOURG STATE: N4 ZIP: L-1882 BUSINESS PHONE: (415) 801-8100 MAIL ADDRESS: STREET 1: 5, RUE GUILLAUME KROLL CITY: LUXEMBOURG STATE: N4 ZIP: L-1882 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Versant Venture Capital IV, L.P. CENTRAL INDEX KEY: 0001456590 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36579 FILM NUMBER: 161661029 BUSINESS ADDRESS: STREET 1: ONE SANSOME STREET STREET 2: SUITE 3630 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 BUSINESS PHONE: 650-233-2211 MAIL ADDRESS: STREET 1: ONE SANSOME STREET STREET 2: SUITE 3630 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Versant Ventures IV, LLC CENTRAL INDEX KEY: 0001456589 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36579 FILM NUMBER: 161661030 BUSINESS ADDRESS: STREET 1: ONE SANSOME STREET STREET 2: SUITE 3630 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 BUSINESS PHONE: 650-233-2211 MAIL ADDRESS: STREET 1: ONE SANSOME STREET STREET 2: SUITE 3630 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 3 1 a3.xml 3 X0206 3 2016-05-11 0 0001501756 Adverum Biotechnologies, Inc. ADVM 0001456589 Versant Ventures IV, LLC ONE SANSOME STREET SUITE 3630 SAN FRANCISCO CA 94104 0 0 1 0 0001456590 Versant Venture Capital IV, L.P. ONE SANSOME STREET SUITE 3630 SAN FRANCISCO CA 94104 0 0 1 0 0001674642 Versant IV Luxco S.a r.l. 5, RUE GUILLAUME KROLL LUXEMBOURG N4 L-1882 LUXEMBOURG 0 0 1 0 0001674481 Versant Capital IV (Switzerland) GmbH AESCHENVORSTADT 36 BASEL V8 4051 SWITZERLAND 0 0 1 0 Common Stock 6660981 I Through Versant Capital IV (Switzerland) GmbH Common Stock 2176 I Through Versant Side Fund IV, L.P. Common Stock 340735 I Through Versant Venture Capital IV, L.P. The shares are owned directly by Versant Capital IV (Switzerland) GmbH ("Versant Switzerland"). Versant Switzerland is wholly owned by Versant IV Luxco S.a r.l. ("Versant Luxembourg") and Versant Luxembourg is majority owned by Versant Venture Capital IV, L.P. and minority owned by Versant Side Fund IV, L.P. (Versant Venture Capital IV, L.P. and Versant Side Fund IV, L.P., collectively, the "Versant Funds"). Versant Ventures IV, LLC ("Ventures IV") is the general partner of each of the Versant Funds. Each of Versant Switzerland, Versant Luxembourg, Versant Venture Capital IV, L.P. and Ventures IV may be deemed a beneficial owner of these shares, but each disclaims such beneficial ownership except to the extent of its pecuniary interest therein. The shares are owned directly by Versant Side Fund IV, L.P. Each of Versant Side Fund IV, L.P. and Ventures IV may be deemed a beneficial owner of these shares, but each disclaims such beneficial ownership except to the extent of its pecuniary interest therein. The shares are owned directly by Versant Venture Capital IV, L.P. Each of Versant Venture Capital IV, L.P. and Ventures IV may be deemed a beneficial owner of these shares, but each disclaims such beneficial ownership except to the extent of its pecuniary interest therein. Versant Ventures IV, LLC By: Robin L. Praeger Its: Managing Director /s/ Robin L. Praeger 2016-05-18 Versant Venture Capital IV, L.P. By: Versant Ventures IV, LLC Its: General Partner By: Robin L. Praeger Its: Managing Director /s/ Robin L. Praeger 2016-05-18 Versant IV Luxco S.a r.l. By: Robin L. Praeger Its: Director /s/ Robin L. Praeger 2016-05-18 Versant Capital IV (Switzerland) GmbH By: Robin L. Praeger Its: Director /s/ Robin L. Praeger 2016-05-18