0001209191-20-052238.txt : 20200928 0001209191-20-052238.hdr.sgml : 20200928 20200928173728 ACCESSION NUMBER: 0001209191-20-052238 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200924 FILED AS OF DATE: 20200928 DATE AS OF CHANGE: 20200928 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ACKERMANN CHRISTINA CENTRAL INDEX KEY: 0001681871 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39538 FILM NUMBER: 201205434 MAIL ADDRESS: STREET 1: 400 SOMERSET CORPORATE BOULEVARD CITY: BRIDGEWATER STATE: NJ ZIP: 08807 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: GRAYBUG VISION, INC. CENTRAL INDEX KEY: 0001534133 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 452120079 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 275 SHORELINE DRIVE, SUITE 450 CITY: REDWOOD CITY STATE: CA ZIP: 94065 BUSINESS PHONE: 650-487-2800 MAIL ADDRESS: STREET 1: 275 SHORELINE DRIVE, SUITE 450 CITY: REDWOOD CITY STATE: CA ZIP: 94065 FORMER COMPANY: FORMER CONFORMED NAME: GRAYBUG, Inc. DATE OF NAME CHANGE: 20150303 FORMER COMPANY: FORMER CONFORMED NAME: GRAYBUG LLC DATE OF NAME CHANGE: 20111102 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-09-24 0 0001534133 GRAYBUG VISION, INC. GRAY 0001681871 ACKERMANN CHRISTINA C/O GRAYBUG VISION, INC. 275 SHORELINE DRIVE, SUITE 450 REDWOOD CITY CA 94065 1 0 0 0 Director Stock Option (Right to Buy) 16.00 2020-09-24 4 A 0 25000 0.00 A 2030-09-23 Common Stock 25000 25000 D The option shall vest as to 1/36th of the total shares on October 24, 2020 and on each monthly anniversary thereafter such that the option shall be fully vested on September 24, 2023, subject to the continued service of the Reporting Person to the Issuer through each vesting date. /s/ Frederic Guerard, as Attorney-in-Fact for Christina Ackermann 2020-09-28