SEC Form 4 · accession 0001209191-16-145764

FIVE PRIME THERAPEUTICS INC · FPRX

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Director

Period of report

Oct 12, 2016

Accepted (ET)

Oct 13, 2016 · 1:02 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001175505

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1	Oct 12, 2016	M	1,220	$1.23	A	1,220	D
Common Stock^F2,F3	holding	—	—		—	15,642	I	By The Robert Lee Douglas Rev Trust dtd 04/30/2015

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Stock Option (right to buy)^F4	$1.23	Oct 12, 2016	M	2,439	D	—	Oct 25, 2016	Common Stock	2,439	0	D

F1Since the date of the reporting person's last ownership report, he transferred 1,219.5 shares of common stock issued upon exercise of an employee stock option to his ex-wife pursuant to a domestic relations order. The reporting person no longer reports as beneficially owned any securities owned by his ex-wife.
F2Since the date of the reporting person's last ownership report, he transferred (i) 13,550 shares of common stock and (ii) 2,092 shares of common stock from The Robert Lee Douglas and Elizabeth A. Strode Revocable Trust dated October 6, 1995 (the "Joint Trust") to his ex-wife pursuant to a domestic relations order. The reporting person no longer reports as beneficially owned any securities owned by his ex-wife.
F3Since the date of the reporting person's last ownership report, he transferred (i) 13,550 shares of common stock to The Robert Lee Douglas Rev Trust dtd 04/30/2015 and (ii) 2,092 shares of common stock from the Joint Trust to The Robert Lee Douglas Rev Trust dtd 04/30/2015.
F4This option was fully vested and immediately exercisable.