0001567619-21-017166.txt : 20210915 0001567619-21-017166.hdr.sgml : 20210915 20210915183558 ACCESSION NUMBER: 0001567619-21-017166 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210913 FILED AS OF DATE: 20210915 DATE AS OF CHANGE: 20210915 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Yednock Ted CENTRAL INDEX KEY: 0001818525 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39402 FILM NUMBER: 211256439 MAIL ADDRESS: STREET 1: C/O ANNEXON, INC. STREET 2: 180 KIMBALL WAY, SUITE 200 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Annexon, Inc. CENTRAL INDEX KEY: 0001528115 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 275414423 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 180 KIMBALL WAY STREET 2: SUITE 200 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 BUSINESS PHONE: (650)-822-5500 MAIL ADDRESS: STREET 1: 180 KIMBALL WAY STREET 2: SUITE 200 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 4 1 doc1.xml FORM 4 X0306 4 2021-09-13 0 0001528115 Annexon, Inc. ANNX 0001818525 Yednock Ted C/O ANNEXON, INC. 180 KIMBALL WAY, SUITE 200 SOUTH SAN FRANCISCO CA 94080 0 1 0 0 EVP & Chief Scientific Officer Common Stock 2021-09-13 4 M 0 15000 1.4096 A 15000 D Common Stock 2021-09-13 4 M 0 1190 5.1098 A 16190 D Common Stock 2021-09-13 4 S 0 16190 20.0037 D 0 D Stock Option (Right to Buy) 1.4096 2021-09-13 4 M 0 15000 0.00 D 2025-01-22 Common Stock 15000 10615 D Stock Option (Right to Buy) 5.1098 2021-09-13 4 M 0 1190 0.00 D 2029-01-22 Common Stock 1190 67939 D The transactions reported herein were effected pursuant to the Reporting Person's Rule 10b5-1 trading plan. This transaction was executed in multiple trades in prices ranging from $20.00 to $20.04, inclusive. The price reported in Column 4 above reflects the weighted average sale price. The Reporting Person hereby undertakes to provide to the Securities and Exchange Commission staff, the Issuer, or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote. The shares subject to the option vest are fully vested and exercisable. 1/48th of the shares subject to the option vest on each monthly anniversary measured from December 12, 2018 (the "Vesting Commencement Date"), such that 100% of the shares subject to the option will be fully vested and exercisable on the fourth anniversary of the Vesting Commencement Date. /s/ Jennifer Lew, as Attorney-in-Fact for Ted Yednock 2021-09-15