SEC Form 4 · accession 0001209191-17-027904
Forte Biosciences, Inc. · FBRX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Faheem Hasnain
Director
Period of report
Apr 19, 2017
Accepted (ET)
Apr 21, 2017 · 5:28 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001419041
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Apr 19, 2017 | J | 102,857 | $10.00 | A | 102,857 | I | By Faheem Hasnain and Marie Hasnain Co-Trustees of the Hasnain Revocable Trust,dtd February 19, 2010 |
| Common Stock | Apr 19, 2017 | P | 100,000 | $10.00 | A | 202,857 | I | By Faheem Hasnain and Marie Hasnain Co-Trustees of the Hasnain Revocable Trust,dtd February 19, 2010 |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Represents the conversion of an outstanding convertible promissory note in the principal amount of $1,000,000, plus $28,575.34 accrued interest, into shares of the Issuer's common stock upon closing of the Issuer's initial public offering at a conversion price of $10.00 per share.
- F2The shares were purchased at the Issuer's initial public offering.