0001274737-22-000041.txt : 20220621 0001274737-22-000041.hdr.sgml : 20220621 20220621083233 ACCESSION NUMBER: 0001274737-22-000041 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220616 FILED AS OF DATE: 20220621 DATE AS OF CHANGE: 20220621 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Birk Brian CENTRAL INDEX KEY: 0001616007 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39049 FILM NUMBER: 221026201 MAIL ADDRESS: STREET 1: C/O EXAGEN INC. STREET 2: 1261 LIBERTY WAY, SUITE C CITY: VISTA STATE: CA ZIP: 92081 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_165581473943886.xml FORM 4 X0306 4 2022-06-16 0 0001274737 EXAGEN INC. XGN 0001616007 Birk Brian 527 DON GASPAR AVENUE SANTA FE NM 87505 1 0 0 0 Stock Option(right to buy) 5.25 2022-06-16 4 A 0 9000 0 A 2032-06-15 Common Stock 9000.0 9000 D The entire number of shares subject to this option becomes fully vested and exercisable on the first to occur of (a) the first anniversary of the grant date or (b) the next occurring annual meeting of the Issuer's stockholders, subject to the Reporting Person's continued service on the board of directors of the Issuer through such vesting date. /s/ Brian Birk 2022-06-21