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