0001209191-20-062756.txt : 20201210
0001209191-20-062756.hdr.sgml : 20201210
20201210171156
ACCESSION NUMBER: 0001209191-20-062756
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201208
FILED AS OF DATE: 20201210
DATE AS OF CHANGE: 20201210
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Zamiri Parisa
CENTRAL INDEX KEY: 0001824806
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39538
FILM NUMBER: 201381417
MAIL ADDRESS:
STREET 1: C/O GRAYBUG VISION, INC.
STREET 2: 275 SHORELINE DRIVE, SUITE 450
CITY: REDWOOD CITY
STATE: CA
ZIP: 94065
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
2020-12-08
0
0001534133
GRAYBUG VISION, INC.
GRAY
0001824806
Zamiri Parisa
C/O GRAYBUG VISION, INC.
275 SHORELINE DRIVE, SUITE 450
REDWOOD CITY
CA
94065
0
1
0
0
Chief Medical Officer
Employee Stock Option (Right to Buy)
23.66
2020-12-08
4
A
0
35000
0.00
A
2030-12-07
Common Stock
35000
35000
D
The stock option vests as to 1/48 of the total shares on January 8, 2021 and each month thereafter until option is fully vested, subject to the Reporting Person's provision of service to the Issuer on each vesting date.
/s/ Frederic Guerard, as Attorney-in-Fact for Parisa Zamiri
2020-12-10