0001209191-22-041378.txt : 20220706
0001209191-22-041378.hdr.sgml : 20220706
20220706185716
ACCESSION NUMBER: 0001209191-22-041378
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220701
FILED AS OF DATE: 20220706
DATE AS OF CHANGE: 20220706
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Holder Michael
CENTRAL INDEX KEY: 0001515140
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39059
FILM NUMBER: 221070184
MAIL ADDRESS:
STREET 1: 6170 RESEARCH RD., STE 103
CITY: FRISCO
STATE: TX
ZIP: 75034
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: 1231
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
2022-07-01
0
0001762303
AVITA Medical, Inc.
RCEL
0001515140
Holder Michael
C/O AVITA MEDICAL, INC.
28159 AVENUE STANFORD, SUITE 220
VALENCIA
CA
91355
0
1
0
0
Chief Financial Officer
Common Stock
2022-07-01
4
A
0
35950
A
46450
D
Stock Options (Right to Buy)
4.97
2022-07-01
4
A
0
20650
0.00
A
2032-07-01
Common Stock
20650
20650
D
Reflects Restricted Stock Units, each representing a contingent right to be issued one share of Common Stock. These Restricted Stock Units vest in four equal annual installments beginning on August 20, 2023.
Includes unvested Restricted Stock Units.
These Stock Options vest in four equal annual installments beginning on August 20, 2023.
/s/ Donna Shiroma, by power of attorney
2022-07-06