0001209191-21-040072.txt : 20210611
0001209191-21-040072.hdr.sgml : 20210611
20210611201818
ACCESSION NUMBER: 0001209191-21-040072
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: Mead Dana G Jr.
CENTRAL INDEX KEY: 0001222358
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39562
FILM NUMBER: 211012914
MAIL ADDRESS:
STREET 1: 2750 SAND HILL ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
FORMER NAME:
FORMER CONFORMED NAME: MEAD DANA G JR
DATE OF NAME CHANGE: 20030310
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
0001222358
Mead Dana G Jr.
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
29125
D
Common Stock
4076
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 received as a liquidation distribution from KPCB XIII Associates, LLC, the managing member of Kleiner Perkins Caufield & Byers XIII, LLC, the direct holder of the shares as disclosed in prior reports.
The shares are held directly by the Dana G. Mead, Jr. And D'Arcy Gage Mead, or Their Successors, as Trustees of The Mead Family Trust Created Uta Dated August 4, 1998, as Amended.
/s/ Lauren Cristina, Attorney-in-Fact for Dana G. Mead Jr.
2021-06-11