0001274737-20-000013.txt : 20200109 0001274737-20-000013.hdr.sgml : 20200109 20200109170938 ACCESSION NUMBER: 0001274737-20-000013 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200109 FILED AS OF DATE: 20200109 DATE AS OF CHANGE: 20200109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rocca Fortunato R. CENTRAL INDEX KEY: 0001492734 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39049 FILM NUMBER: 20518766 MAIL ADDRESS: STREET 1: C/O EXAGEN INC. STREET 2: 1261 LIBERTY WAY, SUITE 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 wf-form4_157860776060573.xml FORM 4 X0306 4 2020-01-09 0 0001274737 EXAGEN INC. XGN 0001492734 Rocca Fortunato R. C/O EXAGEN INC. 1261 LIBERTY WAY, SUITE C VISTA CA 92081 1 1 0 0 President and CEO Stock Option(right to buy) 24.19 2020-01-09 4 A 0 155000 0 A 2030-01-08 Stock Option(right to buy) 155000.0 155000 D The option is exercisable as it vests. 25% of the shares subject to the option vest on January 1, 2021, and 1/48th of the total number of shares subject to the option vest monthly thereafter, subject to the Reporting Person's continued service to the Issuer through each such vesting date. /s/ Kamal Adawi, as attorney-in-fact 2020-01-09