0001209191-16-127169.txt : 20160610
0001209191-16-127169.hdr.sgml : 20160610
20160610183809
ACCESSION NUMBER: 0001209191-16-127169
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160608
FILED AS OF DATE: 20160610
DATE AS OF CHANGE: 20160610
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FIBROGEN INC
CENTRAL INDEX KEY: 0000921299
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 409 ILLINOIS STREET
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94158
BUSINESS PHONE: 415-978-1200
MAIL ADDRESS:
STREET 1: 409 ILLINOIS STREET
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94158
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KEARNS THOMAS F JR
CENTRAL INDEX KEY: 0001189184
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36740
FILM NUMBER: 161709527
MAIL ADDRESS:
STREET 1: P O BOX 587
CITY: WARSAW
STATE: IN
ZIP: 46581-0587
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-06-08
0
0000921299
FIBROGEN INC
FGEN
0001189184
KEARNS THOMAS F JR
C/O FIBROGEN, INC.
409 ILLINOIS ST.
SAN FRANCSICO
CA
94158
1
0
0
0
Stock Option (Right to Buy)
19.05
2016-06-08
4
A
0
12000
0.00
A
2026-06-08
Common Stock
12000
12000
D
The shares subject to the option vest and become exercisable quarterly over one year measured from June 8, 2016.
/s/ Dorothy Pacini, Attorney-in-fact
2016-06-09