0001209191-21-023243.txt : 20210326 0001209191-21-023243.hdr.sgml : 20210326 20210326165635 ACCESSION NUMBER: 0001209191-21-023243 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210325 FILED AS OF DATE: 20210326 DATE AS OF CHANGE: 20210326 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Fuhrmann Rochelle CENTRAL INDEX KEY: 0001509312 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36003 FILM NUMBER: 21778251 MAIL ADDRESS: STREET 1: C/O WARNER CHILCOTT CORPORATION STREET 2: 100 ENTERPRISE DRIVE CITY: ROCKAWAY STATE: NJ ZIP: 07866 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: 10655 SORRENTO VALLEY ROAD STREET 2: SUITE 200 CITY: San Diego STATE: CA ZIP: 92121 BUSINESS PHONE: (858) 526-3100 MAIL ADDRESS: STREET 1: 10655 SORRENTO VALLEY ROAD STREET 2: SUITE 200 CITY: San Diego STATE: CA ZIP: 92121 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 2021-03-25 0 0001383701 Histogen Inc. HSTO 0001509312 Fuhrmann Rochelle C/O HISTOGEN INC. 10655 SORRENTO VALLEY ROAD, SUITE 200 SAN DIEGO CA 92121 1 0 0 0 Stock Option (right to buy) 1.27 2021-03-25 4 A 0 30000 0.00 A 2031-03-25 Common Stock 30000 30000 D The shares subject to the option shall vest in substantially equal installments on each of the first three anniversaries of the grant date, subject to reporting person's continued service as a director on such dates. /s/ Richard W. Pascoe as attorney-in-fact for Rochelle Fuhrmann 2021-03-26