0001274737-22-000008.txt : 20220208 0001274737-22-000008.hdr.sgml : 20220208 20220208161937 ACCESSION NUMBER: 0001274737-22-000008 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220204 FILED AS OF DATE: 20220208 DATE AS OF CHANGE: 20220208 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: 22601855 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_164435515279183.xml FORM 4 X0306 4 2022-02-04 0 0001274737 EXAGEN INC. XGN 0001492734 Rocca Fortunato R. C/O EXAGEN INC. 1261 LIBERTY WAY VISTA CA 92081 1 1 0 0 President and CEO Common Stock 2022-02-04 4 A 0 75000 0 A 125000 D Represents 75,000 restricted stock units. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock. The restricted stock unit will vest with respect to 25% of the restricted stock units on each of the first, second, third and fourth anniversaries of February 4, 2022, 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 75,000 shares of restricted stock units granted on February 4, 2022 and 50,000 shares of restricted stock units granted on February 23, 2021. /s/ Kamal Adawi, as attorney-in-fact 2022-02-08