0001274737-20-000064.txt : 20200702
0001274737-20-000064.hdr.sgml : 20200702
20200702084457
ACCESSION NUMBER: 0001274737-20-000064
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200618
FILED AS OF DATE: 20200702
DATE AS OF CHANGE: 20200702
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Burrell Chet
CENTRAL INDEX KEY: 0001788356
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39049
FILM NUMBER: 201007303
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
wf-form4_159369381976248.xml
FORM 4
X0306
4
2020-06-18
0
0001274737
EXAGEN INC.
XGN
0001788356
Burrell Chet
C/O EXAGEN INC.
1261 LIBERTY WAY
VISTA
CA
92081
1
0
0
0
Stock Option(right to buy)
13.0
2020-06-18
4
A
0
9000
0
A
2030-06-17
Common Stock
9000.0
9000
D
The entire number of shares subject to this option becomes fully vested and exercisable on the first to occur of (a) the first anniversary of the grant date or (b) the next occurring annual meeting of the Issuer's stockholders, subject to the Reporting Person's continued service on the board of directors of the Issuer through such vesting date.
/s/ Kamal Adawi, Attorney-in-Fact
2020-07-02