0001209191-16-144640.txt : 20161004
0001209191-16-144640.hdr.sgml : 20161004
20161004180708
ACCESSION NUMBER: 0001209191-16-144640
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160930
FILED AS OF DATE: 20161004
DATE AS OF CHANGE: 20161004
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Fulgent Genetics, Inc.
CENTRAL INDEX KEY: 0001674930
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071]
IRS NUMBER: 812621304
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4978 SANTA ANITA AVENUE, SUITE 205
CITY: TEMPLE CITY
STATE: CA
ZIP: 91780
BUSINESS PHONE: 626-350-0537
MAIL ADDRESS:
STREET 1: 4978 SANTA ANITA AVENUE, SUITE 205
CITY: TEMPLE CITY
STATE: CA
ZIP: 91780
FORMER COMPANY:
FORMER CONFORMED NAME: Fulgent Diagnostics, Inc.
DATE OF NAME CHANGE: 20160517
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Xi Long USA, Inc.
CENTRAL INDEX KEY: 0001684591
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37894
FILM NUMBER: 161920572
BUSINESS ADDRESS:
STREET 1: #6 XINRUI RD., SCIENCE CITY
STREET 2: LUOGANG DISTRICT
CITY: GUANGZHOU CITY
STATE: F4
ZIP: 510663
BUSINESS PHONE: 86.20.62612188
MAIL ADDRESS:
STREET 1: #6 XINRUI RD., SCIENCE CITY
STREET 2: LUOGANG DISTRICT
CITY: GUANGZHOU CITY
STATE: F4
ZIP: 510663
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-09-30
0
0001674930
Fulgent Genetics, Inc.
FLGT
0001684591
Xi Long USA, Inc.
6 XINRUI ROAD
SCIENCE CITY LUOGANG DISTRICT GUANGZHOU
GUANGDONG PROVINCE
F4
510663
CHINA
0
0
1
0
Issuer Common Stock
2016-09-30
4
J
0
2025623
A
2025623
D
Predecessor Class D-2 Preferred Units
2016-09-30
4
J
0
15394737
D
Predecessor Class D Voting Common Units
15394737
0
D
The securities were received in the Reorganization (as defined below), a transaction exempt under Rule 16b-7 under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), in exchange for the cancellation of 15,394,737 Class D-2 preferred units of Fulgent Therapeutics LLC (the "Predecessor" or "Fulgent LLC").
Reflects securities of the Predecessor. Fulgent LLC is considered the predecessor of the Issuer following completion of a reorganization transaction pursuant to which the Predecessor became a wholly owned subsidiary of the Issuer (the "Reorganization"), which was completed on September 30, 2016 in connection with the Issuer's initial public offering and which is described in the Issuer's Registration Statement on Form S-1, as amended (File No. 333-213469). In the Reorganization, all of the Predecessor's Class D-2 preferred units were cancelled in exchange for shares of the Issuer's common stock at a ratio of 7.6-for-1.
Prior to the Reorganization, the Predecessor's Class D-2 preferred units had no expiration date and were convertible into the Predecessor's Class D voting common units, on a one-for-one basis and for no additional consideration, at any time at the option of the holder and in connection with a qualified initial public offering of the Predecessor or a successor thereof.
The securities were disposed of and cancelled in the Reorganization, a transaction exempt under Rule 16b-7 under the Exchange Act, in exchange for 2,025,623 shares of the Issuer's common stock.
/s/ Paul Kim as Attorney-in-Fact
2016-10-04