0001209191-20-023388.txt : 20200403 0001209191-20-023388.hdr.sgml : 20200403 20200403175155 ACCESSION NUMBER: 0001209191-20-023388 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200401 FILED AS OF DATE: 20200403 DATE AS OF CHANGE: 20200403 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: RHOADS ANN D CENTRAL INDEX KEY: 0001250252 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38554 FILM NUMBER: 20775077 MAIL ADDRESS: STREET 1: 4000 NORTH FIRST STREET CITY: SAN JOSE STATE: CA ZIP: 95134 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Forty Seven, Inc. CENTRAL INDEX KEY: 0001667633 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 474065674 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1490 O'BRIEN DRIVE, SUITE A CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: (650) 352-4150 MAIL ADDRESS: STREET 1: 1490 O'BRIEN DRIVE, SUITE A CITY: MENLO PARK STATE: CA ZIP: 94025 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-04-01 0 0001667633 Forty Seven, Inc. FTSV 0001250252 RHOADS ANN D C/O FORTY SEVEN, INC. 1490 O'BRIEN DRIVE, SUITE A MENLO PARK CA 94025 0 1 0 0 Chief Financial Officer Common Stock 2020-04-01 4 M 0 20950 8.7575 A 39338 D Common Stock 2020-04-01 4 S 0 1924 95.425 D 37414 D Stock Option (right to buy) 8.7575 2020-04-01 4 M 0 20950 0.00 D 2028-04-11 Common Stock 20950 120147 D Includes 6,970 shares acquired under the Forty Seven, Inc. 2018 Employee Stock Purchase Plan. The shares subject to the option vest as follows: 26,710 shares vested 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. /s/ John T. McKenna, Attorney-in-Fact for Ann D. Rhoads 2020-04-03