0001209191-22-059472.txt : 20221202 0001209191-22-059472.hdr.sgml : 20221202 20221202174135 ACCESSION NUMBER: 0001209191-22-059472 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221201 FILED AS OF DATE: 20221202 DATE AS OF CHANGE: 20221202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Eisner Mark CENTRAL INDEX KEY: 0001834161 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36740 FILM NUMBER: 221443176 MAIL ADDRESS: STREET 1: C/O FIBROGEN, INC. STREET 2: 409 ILLINOIS STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94158 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FIBROGEN INC CENTRAL INDEX KEY: 0000921299 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 409 ILLINOIS STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94158 BUSINESS PHONE: 415-978-1200 MAIL ADDRESS: STREET 1: 409 ILLINOIS STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94158 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-12-01 0 0000921299 FIBROGEN INC FGEN 0001834161 Eisner Mark C/O FIBROGEN, INC. 409 ILLINOIS ST. SAN FRANCISCO CA 94158 0 1 0 0 Chief Medical Officer Common Stock 2022-12-01 4 F 0 1084 15.04 D 141183 D Represents shares withheld by the issuer to satisfy a tax obligation realized by the reporting person upon the vesting of restricted stock units. /s/ Cecelia Monoarfa-Taime, Attorney-in-Fact 2022-12-02