0000950170-24-081626.txt : 20240703 0000950170-24-081626.hdr.sgml : 20240703 20240703171141 ACCESSION NUMBER: 0000950170-24-081626 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240701 FILED AS OF DATE: 20240703 DATE AS OF CHANGE: 20240703 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bizily Scott CENTRAL INDEX KEY: 0001920738 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39782 FILM NUMBER: 241100897 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] ORGANIZATION NAME: 03 Life Sciences 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 2024-07-01 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 Officer true Common Stock 2024-07-01 4 M false 1332 6.49 A 3069 D Common Stock 2024-07-01 4 M false 2916 8.04 A 5985 D Common Stock 2024-07-01 4 S false 4248 21.3648 D 1737 D Stock Option (Right To Buy) 6.49 2024-07-01 4 M false 1332 0 D 2032-06-17 Common Stock 1332 11879 D Stock Option (Right To Buy) 8.04 2024-07-01 4 M false 2916 0 D 2032-08-31 Common Stock 2916 33752 D Transaction made pursuant to a 10b5-1 trading plan adopted by the Reporting Person on October 10, 2023. The transaction was executed in multiple trades in prices ranging from $21.01 to $21.74, inclusive. The price reported in Column 4 above reflects the weighted average sale price. The reporting person hereby undertakes to provide to the Securities and Exchange Commission staff, the Issuer, or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote. 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 June 16, 2022 (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. 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 September 1, 2022 (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 2024-07-03