0001209191-16-144562.txt : 20161004 0001209191-16-144562.hdr.sgml : 20161004 20161004175136 ACCESSION NUMBER: 0001209191-16-144562 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160812 FILED AS OF DATE: 20161004 DATE AS OF CHANGE: 20161004 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Fulgent Genetics, Inc. CENTRAL INDEX KEY: 0001674930 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] IRS NUMBER: 812621304 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4978 SANTA ANITA AVENUE, SUITE 205 CITY: TEMPLE CITY STATE: CA ZIP: 91780 BUSINESS PHONE: 626-350-0537 MAIL ADDRESS: STREET 1: 4978 SANTA ANITA AVENUE, SUITE 205 CITY: TEMPLE CITY STATE: CA ZIP: 91780 FORMER COMPANY: FORMER CONFORMED NAME: Fulgent Diagnostics, Inc. DATE OF NAME CHANGE: 20160517 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KIM PAUL CENTRAL INDEX KEY: 0001253820 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37894 FILM NUMBER: 161920455 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-08-12 0 0001674930 Fulgent Genetics, Inc. FLGT 0001253820 KIM PAUL C/O FULGENT GENETICS, INC. 4978 SANTA ANITA AVENUE TEMPLE CITY CA 91780 0 1 0 0 CFO and Treasurer Predecessor Class D Non-Voting Common Units 2016-08-12 4 A 0 500000 A 500000 D Predecessor Class D Non-Voting Common Units 2016-09-30 4 D 0 500000 D 0 D Predecessor Class D Voting Common Units 2016-09-30 4 D 0 2500000 D 0 D Issuer Common Stock 2016-09-30 4 A 0 394736 A 394736 D 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 became a wholly owned subsidiary of the Issuer (the "Reorganization"), which was 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 of the predecessor's Class D voting common units and all restricted share units relating to the Predecessor's Class D non-voting common units were cancelled in exchange for shares of the Issuer's common stock and restricted stock units relating to shares of the Issuer's common stock, respectively, in each case at a ratio of 7.6-for-1. Reflects an award of restricted share units relating to 500,000 of the Predecessor's Class D non-voting common units. Each restricted share unit represents a contingent right to receive one Class D non-voting common unit of the Predecessor. The units subject to the restricted share units vest over a period of four years, with 1/4th of such units vesting 12 months after August 10, 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. Kim's continued service for the Predecessor or the Issuer on each vesting date. The securities were disposed of and cancelled in the Reorganization in exchange for restricted stock units relating to 65,789 shares of the Issuer's common stock. The securities were disposed of and cancelled in the Reorganization in exchange for 328,947 shares of the Issuer's common stock. The securities were received in the Reorganization in exchange for the cancellation of (i) restricted share units relating to 500,000 of the Predecessor's Class D non-voting common units and (ii) 2,500,000 of the Predecessor's Class D voting common units. Includes 328,947 shares of the Issuer's common stock and restricted stock units relating to 65,789 shares of the Issuer's common stock. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock. The shares subject to the restricted stock units vest over a period of four years, with 1/4th of such shares vesting 12 months after August 10, 2016, and 1/16th of the remaining shares vesting at the end of every three-month period over the remaining 36 months, subject to Mr. Kim's continued service for the Predecessor or the Issuer on each vesting date. /s/ Paul Kim 2016-10-04