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