SEC Form 3 · accession 0001209191-18-039600
Forty Seven, Inc. · FTSV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Ann D Rhoads
Officer — Chief Financial Officer
Period of report
Jun 27, 2018
Accepted (ET)
Jun 27, 2018 · 2:25 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001667633
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | holding | — | — | — | 11,418 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F1 | $8.7575 | holding | — | — | — | — | Apr 11, 2028 | Common Stock | 141,097 | — | D |
| Stock Option (right to buy)F2 | $8.7575 | holding | — | — | — | — | Apr 26, 2028 | Common Stock | 74,838 | — | D |
Explanation of responses
- F1The shares subject to the option vest as follows: 26,710 shares vest on March 29, 2019 and the balance of the shares vest in a series of 36 successive equal monthly installments beginning March 29, 2019, subject to Reporting Person's continuous service as of each such date.
- F2The shares subject to the option vest in a series of 48 successive equal monthly installments beginning March 1, 2019, subject to Reporting Person's continuous service as of each such date. The shares subject to this option may be exercised prior to vesting, subject to Issuer's right to repurchase.
Remarks
Exhibit 24 - Power of Attorney