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