0001209191-21-060056.txt : 20211008 0001209191-21-060056.hdr.sgml : 20211008 20211008170334 ACCESSION NUMBER: 0001209191-21-060056 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211006 FILED AS OF DATE: 20211008 DATE AS OF CHANGE: 20211008 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Conterno Enrique A CENTRAL INDEX KEY: 0001476151 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36740 FILM NUMBER: 211315942 MAIL ADDRESS: STREET 1: LILLY CORPORATE CENTER CITY: INDIANAPOLIS STATE: IN ZIP: 46285 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 2021-10-06 0 0000921299 FIBROGEN INC FGEN 0001476151 Conterno Enrique A C/O FIBROGEN, INC. 409 ILLINOIS STREET SAN FRANCISCO CA 94158 1 1 0 0 Chief Executive Officer Common Stock 2021-10-06 4 F 0 1859 10.20 D 134239 D Common Stock 27800 I By Trust 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 2021-10-08