0001209191-21-055405.txt : 20210909 0001209191-21-055405.hdr.sgml : 20210909 20210909213544 ACCESSION NUMBER: 0001209191-21-055405 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210907 FILED AS OF DATE: 20210909 DATE AS OF CHANGE: 20210909 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cotroneo Pat CENTRAL INDEX KEY: 0001621334 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36740 FILM NUMBER: 211245699 MAIL ADDRESS: STREET 1: C/O FIBROGEN, INC. STREET 2: 409 ILLINOIS ST., CITY: SAN FRANCISCO STATE: CA ZIP: 94158 FORMER NAME: FORMER CONFORMED NAME: Controneo Pat DATE OF NAME CHANGE: 20141002 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 2021-09-07 1 0000921299 FIBROGEN INC FGEN 0001621334 Cotroneo Pat C/O FIBROGEN, INC. 409 ILLINOIS ST. SAN FRANCISCO CA 94158 0 1 0 0 Executive Advisor & Former CFO Common Stock 2021-09-07 4 F 0 2141 12.41 D 274536 D Represents shares withheld by the issuer to satisfy a tax obligation realized by the reporting person upon the vesting of restricted stock units. /s/ Dorothy Pacini, Attorney-in-fact 2021-09-09