0001593968-22-001521.txt : 20221013
0001593968-22-001521.hdr.sgml : 20221013
20221013060155
ACCESSION NUMBER: 0001593968-22-001521
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20221010
FILED AS OF DATE: 20221013
DATE AS OF CHANGE: 20221013
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Williams Charles O
CENTRAL INDEX KEY: 0001325818
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39635
FILM NUMBER: 221308015
MAIL ADDRESS:
STREET 1: C/O HERITAGE FINANCIAL GROUP
STREET 2: 721 NORTH WESTOVER BOULEVARD
CITY: ALBANY
STATE: GA
ZIP: 31707
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Surrozen, Inc./DE
CENTRAL INDEX KEY: 0001824893
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 981556622
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 171 OYSTER POINT BLVD
STREET 2: SUITE 400
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
BUSINESS PHONE: 650-475-2820
MAIL ADDRESS:
STREET 1: 171 OYSTER POINT BLVD
STREET 2: SUITE 400
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
FORMER COMPANY:
FORMER CONFORMED NAME: Consonance-HFW Acquisition Corp.
DATE OF NAME CHANGE: 20200915
4
1
primary_01.xml
PRIMARY DOCUMENT
X0306
4
2022-10-10
0001824893
Surrozen, Inc./DE
SRZN
0001325818
Williams Charles O
C/O SURROZEN, INC.
171 OYSTER POINT BLVD., SUITE 400
SOUTH SAN FRANCISCO
CA
94080
false
true
false
false
Chief Financial Officer
Option (right to buy)
5.13
2022-10-10
4
D
false
77972
D
2021-11-30
2030-12-13
Common Stock
77972
0
D
Option (right to buy)
10.25
2022-10-10
4
D
false
2433
D
2022-08-12
2031-08-12
Common Stock
2433
0
D
Option (right to buy)
10.25
2022-10-10
4
D
false
12164
D
2022-08-12
2031-08-12
Common Stock
12164
0
D
Option (right to buy)
5.13
2022-10-10
4
D
false
97676
D
2021-11-30
2030-12-13
Common Stock
97676
0
D
Option (right to buy)
2.16
2022-10-10
4
A
false
12164
A
2022-08-12
2031-08-12
Common Stock
12164
12164
D
Option (right to buy)
2.16
2022-10-10
4
A
false
97676
A
2021-11-30
2030-12-13
Common Stock
97676
97676
D
Option (right to buy)
2.16
2022-10-10
4
A
false
2433
A
2022-08-12
2031-08-12
Common Stock
2433
2433
D
Option (right to buy)
2.16
2022-10-10
4
A
false
77972
A
2021-11-30
2030-12-13
Common Stock
77972
77972
D
The reporting person agreed to cancellation of an option granted to him on 12/14/2020, in exchange for a new option having a lower exercise price.
Twenty-five percent of the shares subject to the Stock Option vests on 11/30/2021, and the remainder vests in 36 equal monthly installments thereafter for the following three years.
The reporting person agreed to cancellation of an option granted to him on 8/12/2021, in exchange for a new option having a lower exercise price.
Twenty-five percent of the shares subject to the Stock Option vests on 8/12/2022, and the remainder vests in 36 equal monthly installments thereafter for the following three years.
/s/Sheela Mohan-Peterson, Attorney-in-Fact for Charles O. Williams
2022-10-12