0001567619-23-003006.txt : 20230214
0001567619-23-003006.hdr.sgml : 20230214
20230214202315
ACCESSION NUMBER: 0001567619-23-003006
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230210
FILED AS OF DATE: 20230214
DATE AS OF CHANGE: 20230214
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: 23633179
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
doc1.xml
FORM 4
X0306
4
2023-02-10
0
0001650648
4D Molecular Therapeutics, Inc.
FDMT
0001920738
Bizily Scott
C/O 4D MOLECULAR THERAPEUTICS INC.
5858 HORTON STREET #455
EMERYVILLE
CA
94608
0
1
0
0
Chief Legal and HR Officer
Stock Option (Right to Buy)
20.24
2023-02-10
4
A
0
50000
0
A
2033-02-09
Common Stock
50000
50000
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 February 10, 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.
/s/ August J. Moretti, Attorney-in-Fact for Scott Bizily
2023-02-14