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