SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
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1. Name and Address of Reporting Person*
Chung Christine

(Last) (First) (Middle)
C/O FIBROGEN, INC.
409 ILLINOIS ST.

(Street)
SAN FRANCISCO CA 94158

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/01/2019
3. Issuer Name and Ticker or Trading Symbol
FIBROGEN INC [ FGEN ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP, China Operations
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 157,937 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) (1) 03/19/2024 Common Stock 3,702 14.58 D
Stock Option (Right to Buy) (1) 03/19/2024 Common Stock 375 14.58 D
Stock Option (Right to Buy) (1) 11/13/2024 Common Stock 3,897 18 D
Stock Option (Right to Buy) (1) 11/13/2024 Common Stock 1,000 18 D
Stock Option (Right to Buy) (1) 03/04/2025 Common Stock 33,579 29.66 D
Stock Option (Right to Buy) (2) 02/22/2026 Common Stock 65,000 19.39 D
Stock Option (Right to Buy) (3) 03/08/2027 Common Stock 75,000 25.4 D
Stock Option (Right to Buy) (4) 03/14/2028 Common Stock 45,000 53.75 D
Stock Option (Right to Buy) (5) 02/05/2029 Common Stock 40,000 57.33 D
Explanation of Responses:
1. Fully vested.
2. Twenty-five percent of the shares subject to the option vested on March 1, 2017, and the remainder vested in equal amounts quarterly thereafter for the following three years.
3. Twenty-five percent of the shares subject to the option vested on March 1, 2018, and the remainder vested in equal amounts quarterly thereafter for the following three years.
4. Twenty-five percent of the shares subject to the option vested on March 1, 2019, and the remainder vested in equal amounts quarterly thereafter for the following three years.
5. Twenty-five percent of the shares subject to the option vests on March 1, 2020, and the remainder vests in equal amounts quarterly thereafter for the following three years.
Remarks:
/s/ Dorothy Pacini, Attorney-in-fact 05/09/2019
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.
LIMITED POWER OF ATTORNEY FOR
SECTION 16 REPORTING OBLIGATIONS

Know all by these presents, that the undersigned hereby makes, constitutes and
appoints each of Pat Cotroneo, Michael Lowenstein, John Alden, Dorothy Pacini,
Melissa Navarro, and certain employees of Cooley LLP, the law firm retained by
FibroGen, Inc., a Delaware corporation (the "Company"), specifically Eric
Steiner, Winston Macaraeg, Clark Chu, and Michael Tenta, as the undersigned's
true and lawful attorney-in-fact, with full power and authority as hereinafter
described on behalf of and in the name, place and stead of the undersigned to:

(1)	prepare, execute, acknowledge, deliver and file Forms 3, 4, and 5 (including
any amendments thereto) with respect to the securities of the Company, with the
SEC, any national securities exchanges and the Company, as considered necessary
or advisable under Section 16(a) of the Securities Exchange Act of 1934, as
amended (the "Exchange Act") and the rules and regulations promulgated
thereunder, as amended from time to time;

(2)	seek or obtain, as the undersigned's representative and on the undersigned's
behalf, information on transactions in the Company's securities from any third
party, including brokers, employee benefit plan administrators and trustees, and
the undersigned hereby authorizes any such person to release any such
information to the undersigned and approves and ratifies any such release of
information; and

(3)	perform any and all other acts which in the discretion of such
attorney-in-fact are necessary or desirable for and on behalf of the undersigned
in connection with the foregoing.

The undersigned acknowledges that:

(1)	this Power of Attorney authorizes, but does not require, such
attorney-in-fact to act in their discretion on information provided to such
attorney-in-fact without independent verification of such information;

(2)	any documents prepared and/or executed by such attorney-in-fact on behalf of
the undersigned pursuant to this Power of Attorney will be in such form and will
contain such information and disclosure as such attorney-in-fact, in his or her
discretion, deems necessary or desirable;

(3)	neither the Company nor such attorney-in-fact assumes (i) any liability for
the undersigned's responsibility to comply with the requirement of the Exchange
Act, (ii) any liability of the undersigned for any failure to comply with such
requirements, or (iii) any obligation or liability of the undersigned for profit
disgorgement under Section 16(b) of the Exchange Act; and

(4)	this Power of Attorney does not relieve the undersigned from responsibility
for compliance with the undersigned's obligations under the Exchange Act,
including without limitation the reporting requirements under Section 16 of the
Exchange Act.

The undersigned hereby gives and grants the foregoing attorney-in-fact full
power and authority to do and perform all and every act and thing whatsoever
requisite, necessary or appropriate to be done in and about the foregoing
matters as fully to all intents and purposes as the undersigned might or could
do if present, hereby ratifying all that such attorney-in-fact of, for and on
behalf of the undersigned, shall lawfully do or cause to be done by virtue of
this Limited Power of Attorney.

This Power of Attorney shall remain in full force and effect until the earlier
to occur of (i) revocation  by the undersigned in a signed writing delivered to
such attorney-in-fact, (ii) the undersigned is no longer required to file Forms
3, 4 and 5 with respect to the undersigned's holdings of and transactions in
securities issued by the Company, or (iii) as to any attorney-in-fact
individually, until such attorney-in-fact shall no longer be employed by the
Company or Cooley LLP, as applicable.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 29th day of April 2019.


							/s/ Christine L. Chung