Steven J. Mento - 10 Mar 2023 Form 4 Insider Report for Histogen Inc.

Reporting relationship: President and CEO, Director
Issuer ticker: N/A
Reported as of: 10 Mar 2023
Net transaction value: $0
SEC form: 4
Accepted by SEC: 14 Mar 2023, 16:32:12 UTC
Prior SEC filing: 09 Nov 2022
Next SEC filing: 05 Jan 2024
Source filing: View source filing
Reporting owner signature: /s/ Susan A. Knudson as attorney-in-fact for Steven J. Mento, Ph.D.

Key filing fact

Steven J. Mento filed Form 4 for Histogen Inc. on 14 Mar 2023.

Key facts

This page summarizes Steven J. Mento's Form 4 filing for Histogen Inc..
4 reported transactions and 4 derivative rows are listed below.
Accepted by SEC: 14 Mar 2023, 16:32.

Change

Previous filing in this sequence was filed on 09 Nov 2022.
Current net transaction value: $0.

Research use

This tells you what this filing adds before you inspect full transaction and derivative tables.
You can trace every row back to the original SEC filing document.

Evidence

Filed on Form 4

Ownership activity is grounded in SEC Form 4 disclosures.

View source filing

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

HSTO transaction Derivative

Stock Option (right to buy)

Award

Transaction value: $0
Shares: +158,055
Change %
Price: $0.000000
Shares after: 158,055
Date: 10 Mar 2023
Ownership: Direct
Underlying class: Common Stock
Underlying amount: 158,055
Exercise price: $0.9500
Footnotes: F1

HSTO transaction Derivative

Stock Option (right to buy)

Award

Transaction value: $0
Shares: +55,532
Change %
Price: $0.000000
Shares after: 55,532
Date: 10 Mar 2023
Ownership: Direct
Underlying class: Common Stock
Underlying amount: 55,532
Exercise price: $0.9500
Footnotes: F1, F2

HSTO transaction Derivative

Stock Option (right to buy)

Disposed to Issuer

Transaction value: $0
Shares: -18,892
Change %: -100%
Price: $0.000000^*
Shares after: 0
Date: 10 Mar 2023
Ownership: Direct
Underlying class: Common Stock
Underlying amount: 18,892
Exercise price: $14.60
Footnotes: F3, F4, F5

HSTO transaction Derivative

Stock Option (right to buy)

Disposed to Issuer

Transaction value: $0
Shares: -7,582
Change %: -100%
Price: $0.000000^*
Shares after: 0
Date: 10 Mar 2023
Ownership: Direct
Underlying class: Common Stock
Underlying amount: 7,582
Exercise price: $5.40
Footnotes: F3, F4, F6

^* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 6 footnotes

Footnote F1

1/4 of the shares subject to the option vest one year after the date of grant, on 3/10/2024, and the remaining 1/36 of the shares vest on a monthly basis thereafter.

Footnote F2

The shares subject to this option are subject to forfeiture in the event that the shares available pursuant to the Issuer's 2020 Incentive Award Plan are not increased prior to the one-year anniversary and vesting of the award by an amount required to be available for issuance for all outstanding stock awards containing this forfeiture condition.

Footnote F3

Effective June 2, 2022, the Issuer effected a 1-for-20 reverse stock split of the Company's issued and outstanding common stock, par value $0.0001 per share.

Footnote F4

On March 10, 2023, the Issuer and the Reporting Person agreed to cancel the stock option award.

Footnote F5

1/4 of the shares subject to the option vested one year after the date of grant, on 11/8/2022, and the remaining 1/36 of the shares vest on a monthly basis thereafter.

Footnote F6

1/4 of the shares subject to the option vested one year after the date of grant, on 2/24/2023, and the remaining 1/36 of the shares vest on a monthly basis thereafter.