0001140361-15-016255.txt : 20150423 0001140361-15-016255.hdr.sgml : 20150423 20150423165726 ACCESSION NUMBER: 0001140361-15-016255 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150421 FILED AS OF DATE: 20150423 DATE AS OF CHANGE: 20150423 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Avalanche 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, SUITE A CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-272-6269 MAIL ADDRESS: STREET 1: 1035 O?BRIEN DRIVE, SUITE A CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chalberg Thomas W. CENTRAL INDEX KEY: 0001614872 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36579 FILM NUMBER: 15789096 MAIL ADDRESS: STREET 1: C/O AVALANCHE BIOTECHNOLOGIES, INC. STREET 2: 1035 O'BRIEN DRIVE, SUITE A CITY: MENLO PARK STATE: CA ZIP: 94025 4 1 doc1.xml FORM 4 X0306 4 2015-04-21 0 0001501756 Avalanche Biotechnologies, Inc. AAVL 0001614872 Chalberg Thomas W. C/O AVALANCHE BIOTECHNOLOGIES, INC. 1035 O'BRIEN DRIVE, SUITE A MENLO PARK CA 94025 1 1 0 0 Chief Executive Officer Common Stock 2015-04-21 4 A 0 23000 0.00 A 308988 D Common Stock 420000 I See Footnote Common Stock 420000 I See Footnote Common Stock 413 I See Footnote Stock Option (Right to Buy) 39.35 2015-04-21 4 A 0 67000 0.00 A 2025-04-20 Common Stock 67000 67000 D Restricted Stock Units ("RSUs"). The Reporting Person is entitled to receive one (1) share of Common Stock of the Issuer for each one (1) RSU upon the vesting thereof. Such RSUs vest with respect to 25% of the shares subject thereto on each of the first, second, third and fourth anniversary of April 21, 2015. The shares are held directly by Thomas W. Chalberg, as Trustee of the Thomas W. Chalberg 2014 Grantor Retained Annuity Trust under agreement dated April 30, 2014. The shares are held directly by the Stefanie R. Chalberg 2014 Grantor Retained Annuity Trust under agreement Dated April 30, 2014. The shares are held directly by the 2009 Chalberg Family Trust, Thomas W. Chalberg, Jr. and Stefanie Raue Chalberg, Trustees. Twenty-five percent (25%) of the shares subject to the option vest and become exercisable on the first anniversary measured from April 21, 2015, and the remaining shares subject to the option vest and become exercisable in 36 successive, equal monthly installments thereafter, subject to the Reporting Person's continued employment or service relationship with the Issuer on each such vesting date. /s/ Michael Swartzburg, Attorney-in-Fact for Thomas W. Chalberg 2015-04-23