0001209191-19-049100.txt : 20190910
0001209191-19-049100.hdr.sgml : 20190910
20190910203121
ACCESSION NUMBER: 0001209191-19-049100
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190906
FILED AS OF DATE: 20190910
DATE AS OF CHANGE: 20190910
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kouchakji Elias
CENTRAL INDEX KEY: 0001775259
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36740
FILM NUMBER: 191086959
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
2019-09-06
0
0000921299
FIBROGEN INC
FGEN
0001775259
Kouchakji Elias
C/O FIBROGEN, INC.
409 ILLINOIS ST.
SAN FRANCISCO
CA
94158
0
1
0
0
SVP, Clinical Dev, Drug Safety
Common Stock
2019-09-06
4
F
0
5541
41.68
D
103658
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/ Dorothy Pacini, Attorney-in-fact
2019-09-10