0001567619-19-001510.txt : 20190123 0001567619-19-001510.hdr.sgml : 20190123 20190123170535 ACCESSION NUMBER: 0001567619-19-001510 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181231 FILED AS OF DATE: 20190123 DATE AS OF CHANGE: 20190123 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Wise Blake CENTRAL INDEX KEY: 0001654446 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36323 FILM NUMBER: 19538001 MAIL ADDRESS: STREET 1: C/O ACHAOGEN, INC. STREET 2: 7000 SHORELINE COURT, #371 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Achaogen, Inc. CENTRAL INDEX KEY: 0001301501 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 680533693 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1 TOWER PLACE STREET 2: SUITE 300 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 BUSINESS PHONE: 650-800-3636 MAIL ADDRESS: STREET 1: 1 TOWER PLACE STREET 2: SUITE 300 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 FORMER COMPANY: FORMER CONFORMED NAME: Achaogen Inc DATE OF NAME CHANGE: 20040825 5 1 doc1.xml FORM 5 X0306 5 2018-12-31 0 0 0 0001301501 Achaogen, Inc. AKAO 0001654446 Wise Blake C/O ACHAOGEN, INC. 1 TOWER PLACE, SUITE #300 SOUTH SAN FRANCISCO CA 94080 0 1 0 0 Chief Executive Officer Common Stock 2018-10-31 5 A 0 L 135000 0.00 A 227721 D Common Stock 178416 I See Footnote Grant of Restricted Stock Units ("RSUs"). The reporting person is entitled to one (1) share of Common Stock for each one (1) RSU upon the vesting thereof. Includes 192,925 RSUs. The shares are held directly by the Blake A. Wise Living Trust. /s/ Gary Loeb, Attorney-in-fact for Blake Wise 2019-01-23