SEC Form 4 · accession 0001209191-19-002922
Forty Seven, Inc. · FTSV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Chris H Takimoto
Officer — Chief Medical Officer
Period of report
Jan 4, 2019
Accepted (ET)
Jan 8, 2019 · 8:17 pm EST
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 | Jan 4, 2019 | M | 8,000 | $2.015 | A | 8,000 | D | |
| Common StockF2 | Jan 4, 2019 | S | 8,000 | $15.5453 | D | 0 | 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)F3 | $2.015 | Jan 4, 2019 | M | 8,000 | D | — | Feb 25, 2026 | Common Stock | 8,000 | 159,741 | D |
Explanation of responses
- F1The sale reported in this Form 4 was effected pursuant to a 10b5-1 trading plan.
- F2The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $15.10 to $16.02, inclusive. The Reporting Person undertakes to provide the Issuer, any securityholder of the Issuer, or the Staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth this footnote.
- F31/4th of the shares subject to the option vested one year after February 8, 2016 and 1/48th of the shares subject to the option vest monthly thereafter, 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.