0001209191-19-012322.txt : 20190221 0001209191-19-012322.hdr.sgml : 20190221 20190221194556 ACCESSION NUMBER: 0001209191-19-012322 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190219 FILED AS OF DATE: 20190221 DATE AS OF CHANGE: 20190221 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Takimoto Chris H CENTRAL INDEX KEY: 0001743780 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38554 FILM NUMBER: 19623706 MAIL ADDRESS: STREET 1: C/O FORTY SEVEN, INC. STREET 2: 1490 O'BRIEN DRIVE, SUITE A CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Forty Seven, Inc. CENTRAL INDEX KEY: 0001667633 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 474065674 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1490 O'BRIEN DRIVE, SUITE A CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: (650) 352-4150 MAIL ADDRESS: STREET 1: 1490 O'BRIEN DRIVE, SUITE A CITY: MENLO PARK STATE: CA ZIP: 94025 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-02-19 0 0001667633 Forty Seven, Inc. FTSV 0001743780 Takimoto Chris H C/O FORTY SEVEN, INC. 1490 O'BRIEN DRIVE, SUITE A MENLO PARK CA 94025 0 1 0 0 Chief Medical Officer Common Stock 2019-02-19 4 S 0 2500 15.0485 D 0 D The sale reported in this Form 4 was effected pursuant to a 10b5-1 trading plan. Reflects shares acquired under the Forty Seven, Inc. 2018 Employee Stock Purchase Plan on February 15, 2019. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $14.91 to $15.55, inclusive. The Reporting Person undertakes to provide the Issuer, any securityholder of the Issuer, or the Staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth this footnote. /s/ John T. McKenna, Attorney-in-Fact for Chris H. Takimoto 2019-02-21