SEC Form 4 · accession 0001225208-18-011387
Forty Seven, Inc. · FTSV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
SUTTER HILL VENTURES
Other
Period of report
Jul 2, 2018
Accepted (ET)
Jul 3, 2018 · 7:42 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 | Jul 2, 2018 | C | 1,052,146 | $0.00 | A | 1,052,146 | D | |
| Common StockF1 | Jul 2, 2018 | C | 945,326 | $0.00 | A | 1,997,472 | D | |
| Common StockF1 | Jul 2, 2018 | C | 774,165 | $0.00 | A | 2,771,637 | D | |
| Common Stock | Jul 2, 2018 | P | 134,735 | $16.00 | A | 2,906,372 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A-1 Preferred StockF1 | — | Jul 2, 2018 | C | 1,052,146 | D | — | — | Common Stock | 1,052,146 | 0 | D |
| Series A-2 Preferred StockF1 | — | Jul 2, 2018 | C | 774,165 | D | — | — | Common Stock | 774,165 | 0 | D |
| Series B Preferred StockF1 | — | Jul 2, 2018 | C | 945,326 | D | — | — | Common Stock | 945,326 | 0 | D |
Explanation of responses
- F1The issuer's preferred stock automatically converted into issuer's common stock on a one-to-one basis immediately upon the closing of the issuer's initial public offering and has no expiration date.