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