0000950170-24-002570.txt : 20240105 0000950170-24-002570.hdr.sgml : 20240105 20240105175110 ACCESSION NUMBER: 0000950170-24-002570 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231130 FILED AS OF DATE: 20240105 DATE AS OF CHANGE: 20240105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shiroma Donna CENTRAL INDEX KEY: 0001816251 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39059 FILM NUMBER: 24517712 MAIL ADDRESS: STREET 1: C/O AVITA MEDICAL STREET 2: 28159 AVENUE STANFORD, SUITE 220 CITY: VALENCIA STATE: CA ZIP: 91355 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AVITA Medical, Inc. CENTRAL INDEX KEY: 0001762303 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] ORGANIZATION NAME: 08 Industrial Applications and Services 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 ownership.xml 4 X0508 4 2023-11-30 0001762303 AVITA Medical, Inc. RCEL 0001816251 Shiroma Donna 28159 AVENUE STANFORD SUITE 220 - AVITA MEDICAL VALENCIA CA 91355 false true false false General Counsel false Common Stock 2023-11-30 4 A false 1469 9.06 A 43726 D Stock Options (Right to Buy) 12.64 2024-01-03 4 A false 100000 0 A 2033-01-03 Common Stock 100000 100000 D These shares were acquired under the AVITA Medical, Inc. Employee Share Purchase Plan ("ESPP") for the ESPP purchase which began July 1, 2023 and ended November 30, 2023 in transactions that were exempt under both Rule 16b-3(d) and Rule 16b-3(c). In accordance with the terms of the ESPP, these shares were purchased at a price equal to 85% of the fair market value closing price of the Company's stock on November 30, 2023 (the purchase date of the offering period). Includes unvested RSUs These Stock Options vest in three equal annual installments beginning the first anniversary of the grant date. /s/ Donna Shiroma 2024-01-05