0001280776-18-000004.txt : 20180104 0001280776-18-000004.hdr.sgml : 20180104 20180104210414 ACCESSION NUMBER: 0001280776-18-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180103 FILED AS OF DATE: 20180104 DATE AS OF CHANGE: 20180104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cox Russell J. CENTRAL INDEX KEY: 0001512984 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36201 FILM NUMBER: 18511898 MAIL ADDRESS: STREET 1: C/O JAZZ PHARMACEUTICALS, PLC STREET 2: 5TH FL, WATERLOO EXCHANGE, WATERLOO RD CITY: DUBLIN L2 4 STATE: L2 ZIP: 0 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 4 1 wf-form4_151511784041634.xml FORM 4 X0306 4 2018-01-03 0 0001280776 VITAL THERAPIES INC VTL 0001512984 Cox Russell J. C/O VITAL THERAPIES, INC. 15010 AVENUE OF SCIENT, SUITE 200 SAN DIEGO CA 92128 1 1 0 0 Chief Executive Officer Non-Qualifed Stock Option (right to buy) 6.3 2018-01-03 4 A 0 1588832 0 A 2028-01-02 Common Stock 1588832.0 1588832 D Twenty five (25%) of the shares of common stock subject to the option shall vest one year from January 3, 2018, and thereafter, one forty-eighth (1/48th) of the shares of common stock subject to the option shall vest monthly, such that all of the shares of common stock subject to the option are vested by January 3, 2022, subject to the reporting person's continuing to be a Service Provider (as defined in the Amended & Restated 2017 Inducement Equity Incentive Plan (the "Plan)) through each vesting date; provided, that, the unvested portion of the option, if any, that would vest during the 12-month period following his termination date had he remained employed by the Issuer through such date shall vest in the event of a termination without cause following a Change in Control (as defined in the Plan). /s/ Michael V. Swanson, as Attorney-in-Fact 2018-01-04