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