0000950170-23-070015.txt : 20231213
0000950170-23-070015.hdr.sgml : 20231213
20231213160518
ACCESSION NUMBER: 0000950170-23-070015
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231211
FILED AS OF DATE: 20231213
DATE AS OF CHANGE: 20231213
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bizily Scott
CENTRAL INDEX KEY: 0001920738
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39782
FILM NUMBER: 231483993
MAIL ADDRESS:
STREET 1: C/O 4D MOLECULAR THERAPEUTICS, INC.
STREET 2: 5858 HORTON STREET #455
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: 4D Molecular Therapeutics, Inc.
CENTRAL INDEX KEY: 0001650648
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 473506994
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 5858 HORTON STREET #455
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
BUSINESS PHONE: 5105052680
MAIL ADDRESS:
STREET 1: 5858 HORTON STREET #455
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
FORMER COMPANY:
FORMER CONFORMED NAME: 4D Molecular Therapeutics Inc.
DATE OF NAME CHANGE: 20200506
FORMER COMPANY:
FORMER CONFORMED NAME: 4D Molecular Therapeutics Inc
DATE OF NAME CHANGE: 20150811
4
1
ownership.xml
4
X0508
4
2023-12-11
0001650648
4D Molecular Therapeutics, Inc.
FDMT
0001920738
Bizily Scott
C/O 4D MOLECULAR THERAPEUTICS INC.
5858 HORTON STREET #455
EMERYVILLE
CA
94608
false
true
false
false
Chief Legal and HR Officer
false
Stock Option (Right to Buy)
14.42
2023-12-11
4
A
false
130000
0
A
2033-12-10
Common Stock
130000
130000
D
The shares underlying the stock option award shall vest and become exercisable as to 1/48th of the underlying shares on each monthly anniversary of December 11, 2023 (the "Vesting Commencement Date"), such that 100% of the shares subject to the option will be fully vested and exercisable on the fourth anniversary of the Vesting Commencement Date, while the grantee remains a service provider to the Company.
By: /s/ Scott Bizily
2023-12-13