0001209191-18-036510.txt : 20180607 0001209191-18-036510.hdr.sgml : 20180607 20180607192804 ACCESSION NUMBER: 0001209191-18-036510 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180605 FILED AS OF DATE: 20180607 DATE AS OF CHANGE: 20180607 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Henderson Jeffrey William CENTRAL INDEX KEY: 0001324015 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36740 FILM NUMBER: 18887817 MAIL ADDRESS: STREET 1: 7000 CARDINAL PLACE CITY: DUBLIN STATE: OH ZIP: 43017 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2018-06-05 0 0000921299 FIBROGEN INC FGEN 0001324015 Henderson Jeffrey William C/O FIBROGEN, INC. 409 ILLINOIS STREET SAN FRANCISCO CA 94158 1 0 0 0 Common Stock 2018-06-05 4 A 0 3700 0.00 A 3700 D Stock Option (Right to Buy) 55.30 2018-06-05 4 A 0 6000 0.00 A 2028-06-05 Common Stock 6000 6000 D Represents the grant of restricted stock units that vest on the earlier of June 6, 2019 or the date of the next annual meeting of stockholders. Options vest on the earlier of June 6, 2019 or the date of the next annual meeting of stockholders. /s/ Dorothy Pacini, Attorney-in-Fact 2018-06-07