Form Type: 4

SEC EDGAR Link
Accession Number:0001209191-21-054742
Date:2021-09-02
Issuer: HISTOGEN INC. (HSTO)
Original Submission Date:

Reporting Person:

KISNER DANIEL L
C/O HISTOGEN INC.
10655 SORRENTO VALLEY ROAD, SUITE 200 SAN DIEGO, CA 92121

Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
Title of SecurityTransaction Date2a. Deemed Execution Date Transaction CodeSharesAcquired or DisposedPrice per share 5. Amount of Securities Beneficially Owned Following Reported Transaction 6. Ownership Form Direct or IndirectNature of Indirect Ownership
Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, convertible securities
Title of Derivative Security Conversion or Exercise Price of Derivative Security Transaction Date Deemed Execution Date Transaction Code Number of Derivative Securities Acquired (A) or Disposed of (D) Date ExercisableExpiration Date Title and Amount of Securities Underlying Derivative Security Price of Derivative Security Number of derivative Securities Beneficially Owned Following Reported Transaction(s) Ownership Form: Direct (D) or Indirect (I) Nature of Indirect Beneficial Ownership
STOCK OPTION (RIGHT TO BUY) 0.822 2021-09-02 deemed execution date A 20,000 (a) 2031-09-02 common stock 20,000 $0.82 20,000 direct
Footnotes
IDfootnote
f1 this option was issued to the reporting person, a non-employee director of the issuer, for his service as a director of the issuer.
f2 the shares subject to this option become fully vested and exercisable on 5/26/2022, subject to the reporting person's continued service on the board of directors of the issuer through such vesting date.

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