0001209191-21-040068.txt : 20210611 0001209191-21-040068.hdr.sgml : 20210611 20210611201422 ACCESSION NUMBER: 0001209191-21-040068 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210601 FILED AS OF DATE: 20210611 DATE AS OF CHANGE: 20210611 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Florin Daniel P CENTRAL INDEX KEY: 0001402459 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39562 FILM NUMBER: 211012909 MAIL ADDRESS: STREET 1: 56 E. BELL DRIVE CITY: WARSAW STATE: IN ZIP: 46581 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Pulmonx Corp CENTRAL INDEX KEY: 0001127537 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 700 CHESAPEAKE DRIVE CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 650-364-0400 MAIL ADDRESS: STREET 1: 700 CHESAPEAKE DRIVE CITY: REDWOOD CITY STATE: CA ZIP: 94063 FORMER COMPANY: FORMER CONFORMED NAME: PULMONX DATE OF NAME CHANGE: 20001031 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-06-01 0 0001127537 Pulmonx Corp LUNG 0001402459 Florin Daniel P C/O PULMONX CORPORATION 700 CHESAPEAKE DRIVE REDWOOD CITY CA 94063 1 0 0 0 Common Stock 2021-06-01 4 A 0 2810 0.00 A 2810 D Common Stock 15789 I See Footnote Represents grant of Restricted Stock Units payable solely in common stock of the Issuer that will vest on the one-year anniversary of the date of grant of June 1, 2021. The shares are directly held by Kelly A Florin Trust, for which the Reporting Person is a trustee. /s/ Lauren Cristina, Attorney-in-Fact for Daniel Philip Florin 2021-06-11