0001209191-21-038372.txt : 20210604
0001209191-21-038372.hdr.sgml : 20210604
20210604183050
ACCESSION NUMBER: 0001209191-21-038372
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210602
FILED AS OF DATE: 20210604
DATE AS OF CHANGE: 20210604
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: 21997759
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
2021-06-02
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
Employee Stock Option (Right to Buy)
4.07
2021-06-02
4
A
0
12500
0.00
A
2031-06-01
Common Stock
12500
12500
D
The option award will fully vest upon the earlier of 1) the Issuer's next annual stockholder meeting, or 2) June 2, 2022, subject to the Reporting Person's provision of service to the Issuer on each vesting date.
/s/ Robert S. Breuil, Attorney-in-Fact
2021-06-04