Filing Details
- Accession Number:
- 0000899243-19-024078
- Form Type:
- 4
- Zero Holdings:
- No
- Publication Time:
- 2019-09-23 21:43:23
- Reporting Period:
- 2019-09-23
- Accepted Time:
- 2019-09-23 21:43:23
- SEC Url:
- Form 4 Filing
Issuer
Cik | Name | Symbol | Sector (SIC) | IRS No |
---|---|---|---|---|
1274737 | Exagen Inc. | XGN | () | 4 |
Insiders
Cik | Name | Reported Address | Insider Title | Director | Officer | Large Shareholder | Other |
---|---|---|---|---|---|---|---|
1050045 | Anthony Tamer | 1450 Brickell Avenue, 31St Floor Miami FL 33131 | No | No | Yes | No | |
1050046 | Sami Mnaymneh | 1450 Brickell Avenue, 31St Floor Miami FL 33131 | No | No | Yes | No | |
1788396 | H.i.g. Bio-Exagen, L.p. | 1450 Brickell Avenue, 31St Floor Miami FL 33131 | No | No | Yes | No | |
1788482 | H.i.g.-Gpii, Inc. | 1450 Brickell Avenue, 31St Floor Miami FL 33131 | No | No | Yes | No |
Reported Non-Derivative Transactions
Sec. Name | Acquisiton - Disposition | Date | Amount | Price | Remaning Holdings | Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
---|---|---|---|---|---|---|---|---|---|---|
Common Stock | Acquisiton | 2019-09-23 | 1,271,252 | $0.00 | 1,271,252 | No | 4 | C | Indirect | See footnote |
Common Stock | Acquisiton | 2019-09-23 | 425,000 | $14.00 | 1,696,252 | No | 4 | P | Indirect | See footnote |
Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
---|---|---|---|---|
No | 4 | C | Indirect | See footnote |
No | 4 | P | Indirect | See footnote |
Reported Derivative Transactions
Sec. Name | Sec. Type | Acquisiton - Disposition | Date | Amount | Price | Amount - 2 | Price - 2 |
---|---|---|---|---|---|---|---|
Common Stock | Series H Redeemable Convertible Preferred Stock | Disposition | 2019-09-23 | 233,446,519 | $0.00 | 1,271,252 | $0.00 |
Remaning Holdings | Exercise Date | Expiration Date | Equity Swap Involved | Transaction Form Type | Transaction Code | Nature of Ownership |
---|---|---|---|---|---|---|
0 | No | 4 | C | Indirect |
Footnotes
- The shares reported on this form are held of record by H.I.G. Bio-Exagen, L.P. ("H.I.G."). H.I.G.-GPII, Inc. ("H.I.G. GP") is the general partner of H.I.G. and has sole voting and investment control over the shares owned by H.I.G. Anthony Tamer and Sami Mnaymneh are the sole shareholders of H.I.G. GP and may be deemed to share beneficial ownership of the shares held by H.I.G. Bio-Exagen, L.P. Each of Mr. Tamer and Mr. Mnaymneh disclaims beneficial ownership of the shares reported herein except to the extent of their pecuniary interest, if any.
- The Series H Redeemable Convertible Preferred Stock ("Series H") is convertible into the Issuer's Common Stock on a 183.635-for-one basis at the holder's election and has no expiration date. The Series H automatically converted into Common Stock upon the closing of the Issuer's initial public offering.