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Filing Details

Accession Number:: 0001567619-20-013817
Form Type:: 4
Zero Holdings:: No
Publication Time:: 2020-07-28 16:17:13
Reporting Period:: 2020-07-28

Accepted Time:: 2020-07-28 16:17:13
SEC Url:: Form 4 Filing

Issuer

Cik	Name	Symbol	Sector (SIC)	IRS No
1528115	Annexon Inc.	ANNX	()	4

Insiders

Cik	Name	Reported Address	Insider Title	Director	Officer	Large Shareholder	Other
1315797	A Muneer Satter	C/O Annexon, Inc. 180 Kimball Way, Suite 200 South San Francisco CA 94080		Yes	No	No	No

Reported Non-Derivative Transactions

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Sec. Name	Acquisiton - Disposition	Date	Amount	Price	Remaning Holdings	Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
Common Stock	Acquisiton	2020-07-28	1,754,978	$0.00	1,754,978	No	4	C	Indirect	See footnote
Common Stock	Acquisiton	2020-07-28	200,000	$17.00	1,954,978	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

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Sec. Name	Sec. Type	Acquisiton - Disposition	Date	Amount	Price	Amount - 2	Price - 2
Common Stock	Series A-1 Preferred Stock	Disposition	2020-07-28	3,095,238	$0.00	351,331	$0.00
Common Stock	Series B Preferred Stock	Disposition	2020-07-28	4,016,573	$0.00	455,909	$0.00
Common Stock	Series C Preferred Stock	Disposition	2020-07-28	5,537,036	$0.00	628,494	$0.00
Common Stock	Series D Preferred Stock	Disposition	2020-07-28	2,812,543	$0.00	319,244	$0.00

Equity Swap Involved	Transaction Form Type	Transaction Code	Nature of Ownership
No	4	C	Indirect
No	4	C	Indirect
No	4	C	Indirect
No	4	C	Indirect

Footnotes

The shares of Series A-1, Series B, Series C and Series D Preferred Stock were automatically converted on a 1-for-8.81 basis into Common Stock immediately prior to the closing of the Issuer's initial public offering.
The amount in Column 5 includes (a) 952,381 shares that are held by the Muneer A. Satter Revocable Trust for which the Reporting Person serves as trustee and, in such capacity, has sole voting and dispositive power over all such shares and (b) 2,142,857 shares that are held by various other trusts and other entities for which the Reporting Person serves as trustee, investment advisor or manager and, in such capacity, has sole voting and dispositive power over all such shares. The Reporting Person disclaims beneficial ownership of all shares included in clause (b) of this footnote (2), except to the extent of his pecuniary interest.
The amount in Column 5 includes (a) 1,162,022 shares that are held by the Muneer A. Satter Revocable Trust for which the Reporting Person serves as trustee and, in such capacity, has sole voting and dispositive power over all such shares and (b) 2,854,551 shares that are held by various other trusts and other entities for which the Reporting Person serves as trustee, investment advisor or manager and, in such capacity, has sole voting and dispositive power over all such shares. The Reporting Person disclaims beneficial ownership of all shares included in clause (b) of this footnote (3), except to the extent of his pecuniary interest.
Represents shares held by Satter Medical Technology Partners, L.P. ("SMTP"), for which the Reporting Person has sole voting and dispositive power over all such shares. The Reporting Person disclaims beneficial ownership of all shares included in this footnote (4), except to the extent of his pecuniary interest.
The amount in Column 5 includes (a) 240,000 shares that are held by the Muneer A. Satter Revocable Trust for which the Reporting Person serves as trustee and, in such capacity, has sole voting and dispositive power over all such shares, (b) 567,240 shares that are held by various other trusts and other entities for which the Reporting Person serves as trustee, investment advisor or manager and, in such capacity, has sole voting and dispositive power over all such shares, and (c) 947,738 shares that are held by SMTP for which the Reporting Person has sole voting and dispositive power over all such shares. The Reporting Person disclaims beneficial ownership of all shares included in clauses (b) and (c) of this footnote (5), except to the extent of his pecuniary interest.
Represents shares purchased by SMTP in connection with the Issuer's initial public offering. These shares of Common Stock were purchased at the public offering price of $17.00 per share.
The amount in Column 5 includes (a) 240,000 shares that are held by the Muneer A. Satter Revocable Trust for which the Reporting Person serves as trustee and, in such capacity, has sole voting and dispositive power over all such shares, (b) 567,240 shares that are held by various other trusts and other entities for which the Reporting Person serves as trustee, investment advisor or manager and, in such capacity, has sole voting and dispositive power over all such shares, and (c) 1,147,738 shares that are held by SMTP for which the Reporting Person has sole voting and dispositive power over all such shares. The Reporting Person disclaims beneficial ownership of all shares included in clauses (b) and (c) of this footnote (7), except to the extent of his pecuniary interest.