0001209191-23-059383.txt : 20231220 0001209191-23-059383.hdr.sgml : 20231220 20231220175356 ACCESSION NUMBER: 0001209191-23-059383 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231218 FILED AS OF DATE: 20231220 DATE AS OF CHANGE: 20231220 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TETRAULT LYNN A. CENTRAL INDEX KEY: 0001645512 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41696 FILM NUMBER: 231502376 MAIL ADDRESS: STREET 1: 12701 COMMONWEALTH DRIVE STREET 2: SUITE 9 CITY: FORT MYERS STATE: FL ZIP: 33913 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ACELYRIN, Inc. CENTRAL INDEX KEY: 0001962918 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] ORGANIZATION NAME: 03 Life Sciences IRS NUMBER: 852406735 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4149 LIBERTY CANYON RD. CITY: AGOURA HILLS STATE: CA ZIP: 91301 BUSINESS PHONE: 805-871-4300 MAIL ADDRESS: STREET 1: 4149 LIBERTY CANYON RD. CITY: AGOURA HILLS STATE: CA ZIP: 91301 4 1 doc4.xml FORM 4 SUBMISSION X0508 4 2023-12-18 0 0001962918 ACELYRIN, Inc. SLRN 0001645512 TETRAULT LYNN A. C/O ACELYRIN, INC. 4149 LIBERTY CANYON RD. AGOURA HILLS CA 91301 1 0 0 0 0 Director Stock Option (right to buy) 7.29 2023-12-18 4 A 0 89955 0.00 A 2033-12-17 Common Stock 89955 89955 D 1/36 of the shares subject to the option vest on January 18, 2024, and 1/36 of the shares subject to the option vest in equal monthly installments thereafter, subject to the Reporting Person's continued service. /s/ Mina Kim, Attorney-in-fact 2023-12-20