0000899243-20-014475.txt : 20200528 0000899243-20-014475.hdr.sgml : 20200528 20200528195351 ACCESSION NUMBER: 0000899243-20-014475 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200526 FILED AS OF DATE: 20200528 DATE AS OF CHANGE: 20200528 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Latterich Martin CENTRAL INDEX KEY: 0001808986 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36003 FILM NUMBER: 20923513 MAIL ADDRESS: STREET 1: C/O HISTOGEN INC. STREET 2: 10655 SORRENTO VALLEY ROAD, SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92121 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Histogen Inc. CENTRAL INDEX KEY: 0001383701 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 203183915 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 16745 WEST BERNARDO DRIVE STREET 2: SUITE 250 CITY: San Diego STATE: CA ZIP: 92127 BUSINESS PHONE: (858) 376-2600 MAIL ADDRESS: STREET 1: 16745 WEST BERNARDO DRIVE STREET 2: SUITE 250 CITY: San Diego STATE: CA ZIP: 92127 FORMER COMPANY: FORMER CONFORMED NAME: Conatus Pharmaceuticals Inc. DATE OF NAME CHANGE: 20140729 FORMER COMPANY: FORMER CONFORMED NAME: Conatus Pharmaceuticals Inc DATE OF NAME CHANGE: 20061214 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-05-26 0 0001383701 Histogen Inc. HSTO 0001808986 Latterich Martin C/O HISTOGEN INC. 10655 SORRENTO VALLEY RD., STE 200 SAN DIEGO CA 92121 0 1 0 0 See Remarks Common Stock 2020-05-26 4 J 0 11951 0.00 A 11951 D Stock Option (right to buy) 3.70 2016-10-07 4 J 0 28684 0.00 A 2026-10-07 Common Stock 28684 28684 D Stock Option (right to buy) 3.84 2018-03-12 4 J 0 14342 0.00 A 2028-03-12 Common Stock 14342 14342 D Shares of common stock of the corporation formerly known as Histogen Inc. ("Histogen") were converted into shares of common stock of the Issuer pursuant to that certain Agreement and Plan of Merger and Reorganization, dated as of January 28, 2020, by and among the Issuer, Chinook Merger Sub, Inc. and Histogen (the "Merger Agreement"). Pursuant to the terms of the Merger Agreement, each share of Histogen common stock was exchanged for 1.4342 shares of the Issuer's common stock (the "Conversion"). Immediately following the merger, the Issuer changed its name to Histogen Inc. All share numbers reflect the one-for-ten reverse stock split (the "Reverse Split") effected by the Issuer immediately prior to the completion of the merger. Shares subject to the option vest in 48 equal monthly installments. Shares subject to the option and the exercise price have been adjusted based upon the Conversion and Reverse Split. Shares subject to the option vest in 48 equal monthly installments. Shares subject to the option and the exercise price have been adjusted based upon the Conversion and Reverse Split. Vice President, Technical Operations /s/ Richard W. Pascoe as attorney-in-fact for Martin Latterich 2020-05-28