0001415889-24-016103.txt : 20240607 0001415889-24-016103.hdr.sgml : 20240607 20240607214136 ACCESSION NUMBER: 0001415889-24-016103 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240605 FILED AS OF DATE: 20240607 DATE AS OF CHANGE: 20240607 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Carson William H. CENTRAL INDEX KEY: 0001824280 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39402 FILM NUMBER: 241031352 MAIL ADDRESS: STREET 1: C/O PREVAIL THERAPEUTICS INC. STREET 2: 430 EAST 29TH STREET, SUITE 1520 CITY: NEW YORK STATE: NY ZIP: 10016 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Annexon, Inc. CENTRAL INDEX KEY: 0001528115 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] ORGANIZATION NAME: 03 Life Sciences IRS NUMBER: 275414423 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1400 SIERRA POINT PARKWAY STREET 2: BLDG C, SUITE 200 CITY: BRISBANE STATE: CA ZIP: 94005 BUSINESS PHONE: (650)-822-5500 MAIL ADDRESS: STREET 1: 1400 SIERRA POINT PARKWAY STREET 2: BLDG C, SUITE 200 CITY: BRISBANE STATE: CA ZIP: 94005 4 1 form4-06082024_010632.xml X0508 4 2024-06-05 0001528115 Annexon, Inc. ANNX 0001824280 Carson William H. C/O ANNEXON, INC. 1400 SIERRA POINT PKWY, BLDG C, STE 200 BRISBANE CA 94005 true false false false 0 Stock Option (Right to Buy) 6.79 2024-06-05 4 A 0 44000 0 A 2034-06-05 Common Stock 44000 44000 D The underlying shares subject to the option vest and become exercisable as to 100% of the total number of shares subject to the option on the earlier of (i) the first anniversary of June 5, 2024 or (ii) the next Annual Meeting following June 5, 2024, subject to Reporting Person's continuous service as a director until such vesting date. /s/ Jennifer Lew, Attorney-in-Fact 2024-06-07