0001225208-18-010937.txt : 20180627 0001225208-18-010937.hdr.sgml : 20180627 20180627173447 ACCESSION NUMBER: 0001225208-18-010937 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20180627 FILED AS OF DATE: 20180627 DATE AS OF CHANGE: 20180627 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SUTTER HILL VENTURES CENTRAL INDEX KEY: 0000879051 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38554 FILM NUMBER: 18922647 BUSINESS ADDRESS: STREET 1: 755 PAGE MILL RD STREET 2: SUITE A200 CITY: PALO ALTO STATE: CA ZIP: 94304 BUSINESS PHONE: 4154935600 MAIL ADDRESS: STREET 1: 755 PAGE MILL RD STREET 2: SUITE A200 CITY: PALO ALTO STATE: CA ZIP: 94304 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 3 1 doc3.xml X0206 3 2018-06-27 0 0001667633 Forty Seven, Inc. FTSV 0000879051 SUTTER HILL VENTURES 755 PAGE MILL ROAD, SUITE A-200 PALO ALTO CA 94304-1005 1 Series A-1 Preferred Stock Common Stock 1052146.0000 D Series A-2 Preferred Stock Common Stock 774165.0000 D Series B Preferred Stock Common Stock 945326.0000 D The issuer's preferred stock will automatically convert into issuer's common stock on a one-to-one basis immediately upon the closing of the issuer's initial public offering and has no expiration date. ftsvshv.txt /s/ Robert Yin, by power of attorney 2018-06-27 EX-24 2 ftsvshv.txt POWER OF ATTORNEY Know all by these presents, that the undersigned hereby authorizes David E. Sweet, Robert Yin, or Patricia Tom to execute for and on behalf of the undersigned Forms 3, 4, and 5, and any Amendments thereto for Forty Seven, Inc. (the "Company"), and cause such form(s) to be filed with the United States Securities and Exchange Commission pursuant to Section 16(a) of the Securities Act of 1934, relating to the undersigned's beneficial ownership of securities in the Company. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney- in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such a capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934. This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned's holdings of, and transactions in, securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact. In witness whereof, the undersigned has caused this Power of Attorney to be executed as of this 26th day of June, 2018. SUTTER HILL VENTURES, A CALIFORNIA LIMITED PARTNERSHIP /s/ Jeffrey W. Bird Managing Director of the General Partner