SEC Form 4 · accession 0001209191-18-040432
Forty Seven, Inc. · FTSV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owners
Christopher J Schaepe
Director · 10% Owner
Barry Eggers
10% Owner
Ravi Mhatre
10% Owner
Peter Nieh
10% Owner
Jeremy Liew
10% Owner
Period of report
Jul 2, 2018
Accepted (ET)
Jul 2, 2018 · 5:16 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 StockF1,F2 | Jul 2, 2018 | C | 1,315,519 | — | A | 1,315,519 | I | See footnote |
| Common StockF2 | Jul 2, 2018 | P | 468,750 | $16.00 | A | 1,784,269 | I | See footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series B Preferred StockF1,F2 | — | Jul 2, 2018 | C | 1,315,519 | D | — | — | Common Stock | 1,315,519 | 0 | I |
Explanation of responses
- F1The Issuer's preferred stock automatically converted into an equal number of shares of Issuer's common stock immediately upon the closing of the Issuer's initial public offering and has no expiration date.
- F2Lightspeed General Partner Select II, L.P., or Select II GP, is the general partner of Lightspeed Venture Partners Select II, L.P., or Lightspeed Select II. Lightspeed Ultimate General Partner Select II, Ltd., or Select II UGP, is the general partner of Select II GP. Christopher J. Schaepe, Barry Eggers, Jeremy Liew, Ravi Mhatre and Peter Nieh are the directors of Select II UGP and share voting and dispositive power with respect to the shares held by Lightspeed Select II. Messrs. Schaepe, Eggers, Liew, Mhatre and Nieh disclaim beneficial ownership of the shares held by Lightspeed Select II except to the extent of their pecuniary interest therein.