0000899243-21-002094.txt : 20210114 0000899243-21-002094.hdr.sgml : 20210114 20210114191731 ACCESSION NUMBER: 0000899243-21-002094 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20210113 FILED AS OF DATE: 20210114 DATE AS OF CHANGE: 20210114 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DARCY THOMAS E CENTRAL INDEX KEY: 0001126910 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38052 FILM NUMBER: 21530137 MAIL ADDRESS: STREET 1: C/O SCIENCE APPLICATIONS INTL CORP STREET 2: 10260 CAMPUS POINT DR. CITY: SAN DIEGO STATE: CA ZIP: 92121 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Forte Biosciences, Inc. CENTRAL INDEX KEY: 0001419041 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 261243872 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1124 W CARSON STREET STREET 2: MRL BUILDING 3-320 CITY: TORRANCE STATE: CA ZIP: 90502 BUSINESS PHONE: (310) 618-6994 MAIL ADDRESS: STREET 1: 1124 W CARSON STREET STREET 2: MRL BUILDING 3-320 CITY: TORRANCE STATE: CA ZIP: 90502 FORMER COMPANY: FORMER CONFORMED NAME: Tocagen Inc DATE OF NAME CHANGE: 20071120 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-01-13 0 0001419041 Forte Biosciences, Inc. FBRX 0001126910 DARCY THOMAS E C/O FORTE BIOSCIENCES, INC. 1124 W. CARSON STREET, MRL BLDG 3-320 TORRANCE CA 90502 1 0 0 0 Common Stock 2021-01-13 4 M 0 500 9.5865 A 2358 D Common Stock 24637 I By Thomas Eric Darcy and Janet E. Darcy, Trustees of the Darcy Family Trust dated September 21, 2001 Stock Option (right to buy) 9.5865 2021-01-13 4 M 0 500 0.00 D 2021-06-15 Common Stock 500 0 D The shares vest in a series of twelve (12) successive equal monthly installments measured from October 3, 2019. The option originally covered 7,500 shares pre 15-to-1 reverse stock split which became effective on June 15, 2020. The Form 4 filed October 4, 2019 incorrectly reported the Expiration Date as October 3, 2029. The correct Expiration Date is June 15, 2021. Exhibit 24 - Power of Attorney /s/ Thomas E. Darcy 2021-01-14 EX-24 2 attachment1.htm EX-24 DOCUMENT

                               POWER OF ATTORNEY

      The undersigned, as a Section 16 reporting person of Forte Biosciences,
Inc. (the "Company"), hereby constitutes and appoints Paul A. Wagner, Antony
Riley, Daniel Koeppen, Benjamin Capps and Thomas Hornish the undersigned's true
and lawful attorneys-in-fact to:

      1.    complete and execute Forms 3, 4 and 5 and other forms and all
            amendments thereto as such attorneys-in-fact shall in their
            discretion determine to be required or advisable pursuant to Section
            16 of the Securities Exchange Act of 1934 (as amended) and the rules
            and regulations promulgated thereunder, or any successor laws and
            regulations, as a consequence of the undersigned's ownership,
            acquisition or disposition of securities of the Company; and

      2.    do all acts necessary in order to file such forms with the
            Securities and Exchange Commission, any securities exchange or
            national association, the Company and such other person or agency as
            the attorneys-in-fact shall deem appropriate.

      The undersigned hereby ratifies and confirms all that said attorneys-in-
fact and agent shall do or cause to be done by virtue hereof.  The undersigned
acknowledges that the foregoing attorneys-in-fact, in serving in such capacity
at the request of the undersigned, is not assuming, nor is the Company assuming,
any of the undersigned's responsibilities to comply with Section 16 of the
Securities Exchange Act of 1934 (as amended).

      This Power of Attorney shall remain in full force and effect until 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,
unless earlier revoked by the undersigned in a signed writing delivered to the
Company and the foregoing attorneys-in-fact.

      IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to
be executed as of this 14th day of January, 2021.


                                     Signature:  /s/ Thomas E. Darcy
                                               --------------------------------

                                     Print Name:  Thomas E. Darcy
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