0001274737-22-000018.txt : 20220302 0001274737-22-000018.hdr.sgml : 20220302 20220302164007 ACCESSION NUMBER: 0001274737-22-000018 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220301 FILED AS OF DATE: 20220302 DATE AS OF CHANGE: 20220302 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hazeltine Mark CENTRAL INDEX KEY: 0001852986 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39049 FILM NUMBER: 22704320 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_164625718287172.xml FORM 4 X0306 4 2022-03-01 0 0001274737 EXAGEN INC. XGN 0001852986 Hazeltine Mark C/O EXAGEN INC. 1261 LIBERTY WAY VISTA CA 92081 0 1 0 0 Chief Operating Officer Common Stock 2022-03-01 4 F 0 3241 7.12 D 99693 D The shares were withheld from the Reporting Person to satisfy the tax withholding obligations that arose upon the vesting of certain restricted stock units granted on February 23, 2021. /s/ Kamal Adawi, as attorney-in-fact 2022-03-02