SEC Form 4 · accession 0001140361-15-001808
Adverum Biotechnologies, Inc. · ADVM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas W. Chalberg
Officer — Chief Executive Officer · Director
Period of report
Dec 12, 2014
Accepted (ET)
Jan 14, 2015 · 5:43 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001501756
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Dec 12, 2014 | M | 413 | $0.21 | A | 371,401 | D | |
| Common Stock | Dec 12, 2014 | G | 413 | $0.00 | D | 370,988 | D | |
| Common StockF2 | Dec 12, 2014 | G | 413 | $0.00 | A | 413 | I | See Footnote |
| Common StockF3 | holding | — | — | — | 420,000 | I | See Footnote | |
| Common StockF4 | holding | — | — | — | 420,000 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy)F5 | $0.21 | Dec 12, 2014 | M | 413 | D | — | Feb 23, 2022 | Common Stock | 413 | 159,587 | D |
Explanation of responses
- F1The reporting person transferred the shares to a family trust for no consideration.
- F2The shares are held directly by the 2009 Chalberg Family Trust, Thomas W. Chalberg, Jr. and Stefanie Raue Chalberg, Trustees
- F3The shares are held directly by Thomas W. Chalberg, as Trustee of the Thomas W. Chalberg 2014 Grantor Retained Annuity Trust under agreement dated April 30, 2014.
- F4The shares are held directly by the Stefanie R. Chalberg 2014 Grantor Retained Annuity Trust under agreement Dated April 30, 2014.
- F5The shares subject to the option vest and become exercisable in 48 successive, equal monthly installments on each monthly anniversary of February 24, 2012, subject to the Reporting Person's continued employment or service relationship with the Issuer on each such vesting date.