0001280776-17-000047.txt : 20170525 0001280776-17-000047.hdr.sgml : 20170525 20170525173222 ACCESSION NUMBER: 0001280776-17-000047 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170523 FILED AS OF DATE: 20170525 DATE AS OF CHANGE: 20170525 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: VITAL THERAPIES INC CENTRAL INDEX KEY: 0001280776 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 15010 AVENUE OF SCIENCE STREET 2: STE. 200 CITY: SAN DIEGO STATE: CA ZIP: 92128 BUSINESS PHONE: 858-673-6840 MAIL ADDRESS: STREET 1: 15010 AVENUE OF SCIENCE STREET 2: STE. 200 CITY: SAN DIEGO STATE: CA ZIP: 92128 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Godshall Douglas Evan CENTRAL INDEX KEY: 0001404227 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36201 FILM NUMBER: 17871083 MAIL ADDRESS: STREET 1: SUITE 4 LEVEL 46 2 PARK STREET CITY: SIDNEY STATE: C3 ZIP: 2000 4 1 wf-form4_149574792815403.xml FORM 4 X0306 4 2017-05-23 0 0001280776 VITAL THERAPIES INC VTL 0001404227 Godshall Douglas Evan C/O VITAL THERAPIES, INC. 15010 AVENUE OF SCIENCE, SUITE 200 SAN DIEGO CA 92128 1 0 0 0 Stock Option (right to buy) 3.2 2017-05-23 4 A 0 45022 0 A 2027-05-22 Common Stock 45022.0 45022 D Subject to the reporting person's continuing to be a Service Provider (as defined in the 2014 Equity Incentive Plan) through the vesting date, 100% of the shares will vest upon the earlier of the one (1) year anniversary from May 23, 2017 or the day prior to the Company's 2018 annual meeting of stockholders. /s/ Michael V. Swanson, by power of attorney 2017-05-25