Statement of Changes in Beneficial Ownership (4)
27 January 2023 - 09:31AM
Edgar (US Regulatory)
FORM 4
[ ] Check this box if no longer subject to Section
16. Form 4 or Form 5 obligations may continue. See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
|
OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
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Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
|
|
1. Name
and Address of Reporting Person * MACKAY GEOFFREY |
2. Issuer Name and Ticker or Trading
Symbol AVROBIO, Inc. [ AVRO ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
President & CEO |
(Last)
(First)
(Middle)
C/O AVROBIO, INC., 100 TECHNOLOGY SQUARE, 6TH
FLOOR |
3. Date of Earliest Transaction (MM/DD/YYYY)
12/28/2022
|
(Street)
CAMBRIDGE, MA 02139
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
6. Individual or Joint/Group Filing
(Check Applicable Line) _X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
12/28/2022 |
|
G |
V |
245123 (1) |
D |
$0 |
142013 |
D |
|
Common Stock |
12/28/2022 |
|
G |
V |
245123 (1) |
A |
$0 |
445123 |
I |
By The Geoff R. MacKay Irrevocable
Trust |
Common Stock |
1/24/2023 |
|
M |
|
45999 |
A |
$.91 |
188012 |
D |
|
Common Stock |
|
|
|
|
|
|
|
72604 |
I |
By daughter of reporting
person |
Common Stock |
|
|
|
|
|
|
|
72604 |
I |
By son of reporting person (2) |
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. Code
(Instr. 8) |
5. Number of Derivative Securities Acquired (A) or
Disposed of (D)
(Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date |
7. Title and Amount of Securities Underlying
Derivative Security
(Instr. 3 and 4) |
8. Price of Derivative Security
(Instr. 5) |
9. Number of derivative Securities Beneficially
Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct
(D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Stock Option (Right to Buy) |
$.91 |
1/24/2023 |
|
M |
|
|
45999 |
(3) |
6/12/2027 |
Common Stock |
45999 |
$0 |
0 |
D |
|
Explanation of
Responses: |
(1) |
This transaction was a bona
fide gift of common stock to The Geoff R. MacKay Irrevocable Trust.
The reporting person disclaims beneficial ownership of the
securities reported herein except to the extent of his pecuniary
interest therein, if any, and this report shall not be deemed an
admission that the reporting person is the beneficial owner of the
securities for purposes of Section 16 of the Securities Exchange
Act of 1934, as amended, or for any other purpose. |
(2) |
The shares were previously
held in a custodial account for the Reporting Person's son,
established pursuant to the Uniform Transfers to Minors Act
("UTMA"), for which the Reporting Person served as custodian. The
shares have since been distributed to the Reporting Person's son,
as required by the terms of the account upon the son attaining the
age of 21. 54,453 shares were subsequently transferred to the Mac
C. MacKay Irrevocable Trust on December 30, 2022. |
(3) |
25% of the shares vested on
June 13, 2018, and the remaining 75% vested in equal monthly
installments thereafter over a three-year period. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
MACKAY GEOFFREY
C/O AVROBIO, INC.
100 TECHNOLOGY SQUARE, 6TH FLOOR
CAMBRIDGE, MA 02139 |
X |
|
President & CEO |
|
Signatures
|
/s/ Steven Avruch, Attorney-in-Fact for Geoffrey
MacKay |
|
1/26/2023 |
**Signature of Reporting
Person |
Date |
Reminder: Report on a separate line for each class
of securities beneficially owned directly or
indirectly. |
* |
If the form is filed by more than one
reporting person, see Instruction 4(b)(v). |
** |
Intentional misstatements or omissions
of facts constitute Federal Criminal Violations. See 18
U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: |
File three copies of this Form, one of
which must be manually signed. If space is insufficient, see
Instruction 6 for procedure. |
Persons who respond to the collection of information
contained in this form are not required to respond unless the form
displays a currently valid OMB control number. |
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