0001209191-17-036894.txt : 20170601
0001209191-17-036894.hdr.sgml : 20170601
20170601180643
ACCESSION NUMBER: 0001209191-17-036894
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170530
FILED AS OF DATE: 20170601
DATE AS OF CHANGE: 20170601
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: AveXis, Inc.
CENTRAL INDEX KEY: 0001652923
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 901038273
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2275 HALF DAY ROAD
STREET 2: SUITE 160
CITY: BANNOCKBURN
STATE: IL
ZIP: 60015
BUSINESS PHONE: 972-725-7797
MAIL ADDRESS:
STREET 1: 2275 HALF DAY ROAD
STREET 2: SUITE 160
CITY: BANNOCKBURN
STATE: IL
ZIP: 60015
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Koh Bong Y
CENTRAL INDEX KEY: 0001615979
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37693
FILM NUMBER: 17885910
MAIL ADDRESS:
STREET 1: 3340 HILLVIEW AVENUE
CITY: PALO ALTO
STATE: CA
ZIP: 94304
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-05-30
0
0001652923
AveXis, Inc.
AVXS
0001615979
Koh Bong Y
C/O AVEXIS, INC.
2275 HALF DAY ROAD, SUITE 200
BANNOCKBURN
IL
60015
1
0
0
0
Stock Option (Right to Buy)
69.25
2017-05-30
4
A
0
2454
0.00
A
2027-05-30
Common Stock
2454
2454
D
The option shall vest and become exercisable (i) in twelve equal monthly installments beginning on June 30, 2017, or (ii) on the date of the Issuer's next annual stockholder meeting, whichever comes first, in each case subject to the Reporting Person's Continuous Service (as that term is defined in the Issuer's 2016 Equity Incentive Plan) through each such date.
The Reporting Person is a member of VR Management, LLC ("Management Company"). Under an agreement between the Reporting Person and the Management Company, the Reporting Person is deemed to hold the reported shares for the sole benefit of the Management Company and must exercise the reported shares solely upon the direction of the Management Company, which is entitled to the shares. The Management Company may be deemed the indirect beneficial owner of the reported shares, and the Reporting Person may be deemed the indirect beneficial owner of the reported shares through his interest in the Management Company. The Reporting Person disclaims beneficial ownership of the reported shares except to the extent of his pecuniary interest therein.
/s/ Madison Jones, Attorney-in-Fact
2017-06-01