0001274737-21-000087.txt : 20210730 0001274737-21-000087.hdr.sgml : 20210730 20210730082719 ACCESSION NUMBER: 0001274737-21-000087 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210729 FILED AS OF DATE: 20210730 DATE AS OF CHANGE: 20210730 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hooker Ana CENTRAL INDEX KEY: 0001774825 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39049 FILM NUMBER: 211130191 MAIL ADDRESS: STREET 1: 441 CHARMANY DRIVE CITY: MADISON STATE: WI ZIP: 53719 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: EXAGEN INC. CENTRAL INDEX KEY: 0001274737 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1261 LIBERTY WAY CITY: VISTA STATE: CA ZIP: 92081 BUSINESS PHONE: (760) 560-1501 MAIL ADDRESS: STREET 1: 1261 LIBERTY WAY CITY: VISTA STATE: CA ZIP: 92081 FORMER COMPANY: FORMER CONFORMED NAME: EXAGEN DIAGNOSTICS INC DATE OF NAME CHANGE: 20031230 4 1 wf-form4_162764802438621.xml FORM 4 X0306 4 2021-07-29 0 0001274737 EXAGEN INC. XGN 0001774825 Hooker Ana C/O EXAGEN INC. 1261 LIBERTY WAY VISTA CA 92081 1 0 0 0 Stock Option(right to buy) 12.28 2021-07-29 4 A 0 15000 0 A 2031-07-28 Common Stock 15000.0 15000 D The option is exercisable as it vests. The total number of shares of common stock subject to the option vests in 36 equal monthly installments over the three-year period beginning on August 29, 2021, subject to the Reporting Person's continued service to the Issuer through each such vesting date. /s/ Kamal Adawi, as attorney-in-fact 2021-07-30