0001628280-16-016759.txt : 20160526 0001628280-16-016759.hdr.sgml : 20160526 20160526164917 ACCESSION NUMBER: 0001628280-16-016759 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160524 FILED AS OF DATE: 20160526 DATE AS OF CHANGE: 20160526 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: 161678831 MAIL ADDRESS: STREET 1: SUITE 4 LEVEL 46 2 PARK STREET CITY: SIDNEY STATE: C3 ZIP: 2000 4 1 wf-form4_146429574355346.xml FORM 4 X0306 4 2016-05-24 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) 8.17 2016-05-24 4 A 0 21599 0 A 2026-05-23 Common Stock 21599.0 21599 D Subject to 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 subject to the option shall vest and become exercisable upon the earlier of the one (1) year anniversary from May 24, 2016 or the day prior to the Company's 2017 annual meeting of stockholders. /s/ Michael V. Swanson, by power of attorney 2016-05-26