0001209191-18-047666.txt : 20180820 0001209191-18-047666.hdr.sgml : 20180820 20180820181547 ACCESSION NUMBER: 0001209191-18-047666 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180816 FILED AS OF DATE: 20180820 DATE AS OF CHANGE: 20180820 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SCHAEPE CHRISTOPHER J CENTRAL INDEX KEY: 0001185068 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38554 FILM NUMBER: 181029132 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Forty Seven, Inc. CENTRAL INDEX KEY: 0001667633 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 474065674 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1490 O'BRIEN DRIVE, SUITE A CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: (650) 352-4150 MAIL ADDRESS: STREET 1: 1490 O'BRIEN DRIVE, SUITE A CITY: MENLO PARK STATE: CA ZIP: 94025 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2018-08-16 0 0001667633 Forty Seven, Inc. FTSV 0001185068 SCHAEPE CHRISTOPHER J 2200 SAND HILL ROAD MENLO PARK CA 94025 1 0 1 0 Common Stock 2018-08-16 4 P 0 66542 15.0283 A 66542 I By Schaepe-Chiu Investments I LP - Fund 1 Common Stock 67036 I By Lightspeed Affiliates X, L.P. Common Stock 2474368 I By Lightspeed Venture Partners X, L.P. Common Stock 1784269 I By Lightspeed Venture Partners Select II, L.P. The price reported is a weighted-average purchase price. The shares were purchased in multiple transactions at prices ranging from $14.79 to $15.25, inclusive. The Reporting Person undertakes to provide to Issuer, any security holder of Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price. Shares held by Schaepe-Chiu Investments I LP - Fund 1. Reporting Person serves as co-trustee of the general partner of such entity. Shares are held by Lightspeed Affiliates X, L.P., or Lightspeed Affiliates. Lightspeed General Partner X, L.P., or Lightspeed GP X, is the general partner of Lightspeed X and Lightspeed Affiliates. Lightspeed Ultimate General Partner X, Ltd., or Lightspeed UGP X, is the general partner of Lightspeed GP X. Christopher J. Schaepe, Barry Eggers, Ravi Mhatre, Peter Nieh and Jeremy Liew are the directors of Lightspeed UGP X and share voting and dispositive power with respect to the shares held by Lightspeed X and Lightspeed Affiliates. The Reporting Person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. Shares are held by Lightspeed Venture Partners X, L.P., or Lightspeed X. Shares are held by Lightspeed Venture Partners Select II, L.P., or Lightspeed Select II. Lightspeed General Partner Select II, L.P., or Select II GP, is the general partner of Lightspeed Select II. Lightspeed Ultimate General Partner Select II, Ltd., or Select II UGP, is the general partner of Select II GP. Messrs. Schaepe, Eggers, Mhatre, Nieh and Liew are the directors of Select II UGP and share voting and dispositive power with respect to the shares held by Lightspeed Select II. The Reporting Person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. /s/ Christopher J. Schaepe 2018-08-20