0001610717-23-000153.txt : 20230612 0001610717-23-000153.hdr.sgml : 20230612 20230612182353 ACCESSION NUMBER: 0001610717-23-000153 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230608 FILED AS OF DATE: 20230612 DATE AS OF CHANGE: 20230612 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: 231009700 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 form4.xml X0407 4 2023-06-08 0001650648 4D Molecular Therapeutics, Inc. FMDT 0001920738 Bizily Scott C/O 4D MOLECULAR THERAPEUTICS, INC. 5858 HORTON STREET #455 EMERYVILLE CA 94608 true Chief Legal and HR Officer false Common Stock 2023-06-08 4 M 0 3750 8.04 A 5487 D Common Stock 2023-06-08 4 S 0 3750 20.85 D 1737 D Stock Option (Right to Buy) 8.04 2023-06-08 4 M 0 3750 0 D 2032-08-31 Common Stock 3750 48750 D Transaction made pursuant to a 10b5-1 trading plan adopted by the Reporting Person intended to comply with the prior version of rule 10b5-1. 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. /s/ August Moretti as Attorney-in-fact for Scott Bizily 2023-06-12