0001274737-21-000010.txt : 20210225 0001274737-21-000010.hdr.sgml : 20210225 20210225170545 ACCESSION NUMBER: 0001274737-21-000010 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210223 FILED AS OF DATE: 20210225 DATE AS OF CHANGE: 20210225 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Adawi Kamal CENTRAL INDEX KEY: 0001788393 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39049 FILM NUMBER: 21681488 MAIL ADDRESS: STREET 1: C/O EXAGEN INC. STREET 2: 1261 LIBERTY WAY, SUITE C CITY: VISTA STATE: CA ZIP: 92131 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_161429071161279.xml FORM 4 X0306 4 2021-02-23 0 0001274737 EXAGEN INC. XGN 0001788393 Adawi Kamal C/O EXAGEN INC. 1261 LIBERTY WAY VISTA CA 92081 0 1 0 0 Chief Financial Officer Common Stock 2021-02-23 4 A 0 37500 0 A 37500 D Stock Option(right to buy) 18.2 2021-02-23 4 A 0 12500 0 A 2031-02-22 Common Stock 12500.0 12500 D Represents restricted stock units. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock. The restricted stock units will vest with respect to 25% of the restricted stock units on each of the first, second, third and fourth anniversaries of March 1, 2020, subject to the Reporting Person's continued service through the applicable vesting date. In addition, the award may become fully vested upon a qualifying termination of employment in connection with a change in control. Represents 37,500 shares of restricted stock units. The option is exercisable as it vests. 25% of the shares subject to the option vest on February 23, 2022, 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. In addition, the stock option may become fully vested upon a qualifying termination of employment in connection with a change in control. /s/ Kamal Adawi 2021-02-25