0001610717-23-000142.txt : 20230612 0001610717-23-000142.hdr.sgml : 20230612 20230612164825 ACCESSION NUMBER: 0001610717-23-000142 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230608 FILED AS OF DATE: 20230612 DATE AS OF CHANGE: 20230612 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cockroft Bettina M. CENTRAL INDEX KEY: 0001900452 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39402 FILM NUMBER: 231008782 MAIL ADDRESS: STREET 1: C/O ANNEXON, INC. STREET 2: 180 KIMBALL WAY, SUITE 200 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Annexon, Inc. CENTRAL INDEX KEY: 0001528115 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 275414423 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1400 SIERRA POINT PARKWAY STREET 2: BLDG C, SUITE 200 CITY: BRISBANE STATE: CA ZIP: 94005 BUSINESS PHONE: (650)-822-5500 MAIL ADDRESS: STREET 1: 1400 SIERRA POINT PARKWAY STREET 2: BLDG C, SUITE 200 CITY: BRISBANE STATE: CA ZIP: 94005 4 1 form4.xml X0407 4 2023-06-08 0001528115 Annexon, Inc. ANNX 0001900452 Cockroft Bettina M. C/O ANNEXON, INC. 1400 SIERRA POINT PKWY, BLDG C, STE 200 BRISBANE CA 94005 true false Stock Option (Right to Buy) 2.88 2023-06-08 4 A 0 24000 0 A 2033-06-08 Common Stock 24000 24000 D The underlying shares subject to the option vest and become exercisable as to 100% of the total number of shares subject to the option on the earlier of (i) the first anniversary of June 8, 2023 or (ii) the next Annual Meeting following June 8, 2023, subject to Reporting Person's continuous service as a director until such vesting date. /s/ Jennifer Lew, as Attorney-in-Fact for Bettina M. Cockroft 2023-06-12