0001209191-20-021486.txt : 20200327
0001209191-20-021486.hdr.sgml : 20200327
20200327180717
ACCESSION NUMBER: 0001209191-20-021486
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200311
FILED AS OF DATE: 20200327
DATE AS OF CHANGE: 20200327
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PALLARES EBETUEL
CENTRAL INDEX KEY: 0001614597
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39049
FILM NUMBER: 20753234
MAIL ADDRESS:
STREET 1: C/O EXAGEN INC.
STREET 2: 1261 LIBERTY WAY, SUITE C
CITY: VISTA
STATE: CA
ZIP: 92081
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
2020-03-11
0
0001274737
EXAGEN INC.
XGN
0001614597
PALLARES EBETUEL
C/O EXAGEN INC.
1261 LIBERTY WAY, SUITE C
VISTA
CA
92081
1
0
0
0
Common Stock
2020-03-11
4
M
0
22427
1.84
A
144094
I
See footnote
Common Stock
2020-03-11
4
F
0
2112
19.507
D
141982
I
See footnote
Common Stock
2020-03-11
4
M
0
2265
1.84
A
144247
I
See footnote
Common Stock
2020-03-11
4
F
0
214
19.507
D
144033
I
See footnote
Warrants
1.84
2020-03-11
4
M
0
22427
0.00
D
Common Stock
22427
0
I
See footnote
Warrants
1.84
2020-03-11
4
M
0
2265
0.00
D
Common Stock
2265
0
I
See footnote
The shares reported on this form are held of record by PCM/Exagen, L.P. ("PCM"). Ebetuel Pallares is a co-manager of PCM. As a result, each of PCM and Dr. Pallares may be deemed to share beneficial ownership of the shares held of record by PCM.
Represents the cashless net exercise of a warrant through the surrender of shares to the Issuer based on a fair market value of $19.507 per share, as determined by the average closing price of the Issuer's common stock for the ten trading days immediately preceding the date of exercise.
The warrants are currently exercisable and will expire on January 19, 2026.
The warrants are currently exercisable and will expire on March 31, 2026.
/s/ Kamal Adawi, as attorney-in-fact
2020-03-27