0001209191-20-023395.txt : 20200403 0001209191-20-023395.hdr.sgml : 20200403 20200403175327 ACCESSION NUMBER: 0001209191-20-023395 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200401 FILED AS OF DATE: 20200403 DATE AS OF CHANGE: 20200403 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: 20775086 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 2020-04-01 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 2020-04-01 4 M 0 49627 2.015 A 53533 D Common Stock 2020-04-01 4 M 0 8333 4.8825 A 61866 D Common Stock 2020-04-01 4 M 0 7020 5.27 A 68886 D Common Stock 2020-04-01 4 M 0 11418 8.7575 A 80304 D Common Stock 2020-04-01 4 M 0 2797 35.75 A 83101 D Common Stock 2020-04-01 4 S 0 79195 95.42 D 3906 D Stock Option (right to buy) 2.015 2020-04-01 4 M 0 49627 0.00 D 2020-02-08 2026-02-25 Common Stock 49627 58114 D Stock Option (right to buy) 4.8825 2020-04-01 4 M 0 8333 0.00 D 2027-08-14 Common Stock 8333 4570 D Stock Option (right to buy) 5.27 2020-04-01 4 M 0 7020 0.00 D 2027-11-27 Common Stock 7020 70398 D Stock Option (right to buy) 8.7575 2020-04-01 4 M 0 11418 0.00 D 2028-04-26 Common Stock 11418 44710 D Stock Option (right to buy) 35.75 2020-04-01 4 M 0 2797 0.00 D 2029-12-12 Common Stock 2797 113153 D Includes 3,906 shares acquired under the Forty Seven, Inc. 2018 Employee Stock Purchase Plan. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $95.411 to $95.43, 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 in this footnote. The shares subject to the option vest in a series of 48 successive equal monthly installments commencing on August 15, 2017, subject to Reporting Person's continuous service as of each such date. The shares subject to the option vest in a series of 48 successive equal monthly installments commencing on November 8, 2017, subject to Reporting Person's continuous service as of each such date. The shares subject to the option vest in a series of 48 successive equal monthly installments commencing on March 1, 2019, subject to Reporting Person's continuous service as of each such date. The shares subject to the option vest in a series of 48 successive equal monthly installments commencing on December 13, 2019, subject to Reporting Person's continuous service as of each such date. /s/ John T. McKenna, Attorney-in-Fact for Chris H. Takimoto 2020-04-03