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