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^*

BOLGER JOHN C

(Last)

(First)

(Middle)

C/O FULGENT GENETICS, INC.

4978 SANTA ANITA AVENUE

(Street)

TEMPLE CITY

91780

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
09/28/2016

3. Issuer Name and Ticker or Trading Symbol
Fulgent Genetics, Inc. [ FLGT ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

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)

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)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	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)
Predecessor Unit Option (Right to Buy)⁽¹⁾	⁽²⁾	02/22/2026	Predecessor Class D Non-Voting Common Units	20,000	$0.05	D
Predecessor Unit Option (Right to Buy)⁽¹⁾	⁽³⁾	04/12/2026	Predecessor Class D Non-Voting Common Units	20,000	$0.05	D
Predecessor Unit Option (Right to Buy)⁽¹⁾	⁽⁴⁾	06/21/2026	Predecessor Class D Non-Voting Common Units	20,000	$1.62	D

Explanation of Responses:

1. Reflects securities of Fulgent Therapeutics LLC (the "Predecessor" or "Fulgent LLC"). Fulgent LLC is considered the predecessor of Fulgent Genetics, Inc. (the "Issuer") following completion of a reorganization transaction pursuant to which the Predecessor will become a wholly owned subsidiary of the Issuer (the "Reorganization"), which will be completed on September 30, 2016 in connection with the initial public offering of the Issuer and which is described in the Issuer's Registration Statement on Form S-1, as amended (File No. 333-213469). In the Reorganization, all options to purchase the Predecessor's Class D non-voting common units will be cancelled in exchange for options to purchase shares of the Issuer's common stock at a ratio of 7.6-for-1.

2. The units subject to the option vest over a period of four years, with 1/4th of such units vesting 12 months after February 23, 2016, and 1/16th of the remaining units vesting at the end of every three-month period over the remaining 36 months, subject to Mr. Bolger's continued service for the Predecessor or the Issuer on each vesting date.

3. The units subject to the option vest over a period of four years, with 1/4th of such units vesting 12 months after April 13, 2016, and 1/16th of the remaining units vesting at the end of every three-month period over the remaining 36 months, subject to Mr. Bolger's continued service for the Predecessor or the Issuer on each vesting date.

4. The units subject to the option vest over a period of four years, with 1/4th of such units vesting 12 months after June 22, 2016, and 1/16th of the remaining units vesting at the end of every three-month period over the remaining 36 months, subject to Mr. Bolger's continued service for the Predecessor or the Issuer on each vesting date.

Remarks:

Exhibit list: Exhibit 24 Power of Attorney.

	/s/ Paul Kim as Attorney-in-Fact	09/28/2016
	** 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).
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