0001209191-20-021043.txt : 20200324
0001209191-20-021043.hdr.sgml : 20200324
20200324195036
ACCESSION NUMBER: 0001209191-20-021043
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200320
FILED AS OF DATE: 20200324
DATE AS OF CHANGE: 20200324
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: TULLIS JAMES L L
CENTRAL INDEX KEY: 0001230641
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39049
FILM NUMBER: 20739655
MAIL ADDRESS:
STREET 1: 100 FIRST STAMFORD PLACE
CITY: STAMFORD
STATE: CT
ZIP: 06907
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: EXAGEN INC.
CENTRAL INDEX KEY: 0001274737
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1261 LIBERTY WAY
CITY: VISTA
STATE: CA
ZIP: 92081
BUSINESS PHONE: (760) 560-1501
MAIL ADDRESS:
STREET 1: 1261 LIBERTY WAY
CITY: VISTA
STATE: CA
ZIP: 92081
FORMER COMPANY:
FORMER CONFORMED NAME: EXAGEN DIAGNOSTICS INC
DATE OF NAME CHANGE: 20031230
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2020-03-20
0
0001274737
EXAGEN INC.
XGN
0001230641
TULLIS JAMES L L
1770 US HIGHWAY ONE, SUITE 503
PALM BEACH GARDENS
FL
33408
1
0
1
0
Common Stock
2020-03-20
4
J
0
164420
0.00
D
1625165
I
See footnote
Common Stock
41592
D
Common Stock
1431
I
By Spouse
Common Stock
4537
I
By Trust
Tullis and Tullis Growth, respectively, (as each is defined in Footnote (2) below) distributed in the aggregate 164,420 shares of Common Stock of Exagen Inc. to their respective non-affiliate limited partners on a pro rata basis, for no consideration.
The shares reported on this form are held of record by Tullis-Dickerson Capital Focus III, L.P. ("Tullis"), Tullis Growth Fund, L.P. ("Tullis Growth") and Tullis Growth Fund II, L.P. ("Tullis Growth II"). Tullis-Dickerson Partners III, LLC ("Tullis Partners") is the general partner of Tullis and may be deemed to beneficially own the securities held by Tullis. Tullis Growth Partners, LLC and Tullis Growth Partners II, LLC are the general partners of Tullis Growth and Tullis Growth II, respectively, and may be deemed to beneficially own the securities held by Tullis Growth and Tullis Growth II. James L.L. Tullis is a Principal of each of the foregoing entities and may be deemed to possess voting and investment control over, and may be deemed to have an indirect beneficial ownership with respect to, the shares held by Tullis, Tullis Growth and Tullis Growth II.
/s/ James L.L. Tullis
2020-03-24