- Initial Statement of Beneficial Ownership (3)
16 Settembre 2009 - 12:24AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0104
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
BURLINGAME ASSET MANAGEMENT, LLC
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2. Date of Event Requiring Statement (MM/DD/YYYY)
9/10/2009
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3. Issuer Name
and
Ticker or Trading Symbol
AVIGEN INC DE [AVGN]
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(Last)
(First)
(Middle)
1 MARKET STREET, SUITE 3750
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
___
X
___ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Street)
SAN FRANCISCO, CA 94105
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
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2254724
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D
(1)
(5)
(6)
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Common Stock
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263004
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D
(2)
(5)
(6)
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Common Stock
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140000
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D
(3)
(5)
(6)
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Common Stock
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407047
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D
(4)
(5)
(6)
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Explanation of Responses:
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(
1)
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Represents shares of common stock owned directly by Burlingame Equity Investors, LP ("Domestic Fund"), a Delaware limited
partnership.
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(
2)
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Represents shares of common stock owned directly by Burlingame Equity Investors II, LP ("Domestic Fund II"), a Delaware
limited partnership.
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(
3)
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Represents shares of common stock owned directly by Burlingame Special Opportunities III, LP (the "BSO III Fund"), a Delaware
limited partnership.
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(
4)
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Represents shares of common stock owned directly by Burlingame Equity Investors (Offshore) Ltd. ("Offshore Fund"), a Cayman
Islands exempted company.
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(
5)
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Burlingame Asset Management, LLC ("BAM"), a Delaware limited liability company, is the general partner of each of the
Domestic Fund, Domestic Fund II and BSO III Fund, and the investment manager of the Offshore Fund. BAM, in its capacity as
general partner and investment manager, respectively, of the Domestic Fund, Domestic Fund II, BSO III Fund and the Offshore
Fund (collectively, the "Funds"), may be deemed to indirectly own the shares of common stock owned by the Funds. Blair E.
Sanford, as the controlling person of BAM, may be deemed to indirectly own the shares of common stock owned by BAM.
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(
6)
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Pursuant to Rule 16a-1(4) promulgated under the Securities Exchange Act of 1934, as amended, each of BAM, Domestic Fund,
Dometic Fund II, BSO III Fund, Offshore Fund and Mr. Sanford herein states that the filing of this Form 3 and the statements
made herein shall not be deemed an admission that he or it is the beneficial owner of any of the securities covered by this
Form.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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BURLINGAME ASSET MANAGEMENT, LLC
1 MARKET STREET
SUITE 3750
SAN FRANCISCO, CA 94105
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X
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Signatures
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Blair E. Sanford, Managing Member of Burlingame Asset Management, LLC
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9/15/2009
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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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