0001209191-20-023385.txt : 20200403 0001209191-20-023385.hdr.sgml : 20200403 20200403175041 ACCESSION NUMBER: 0001209191-20-023385 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: McCamish Mark Anthony CENTRAL INDEX KEY: 0001390798 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38554 FILM NUMBER: 20775069 MAIL ADDRESS: STREET 1: C/O FORTY SEVEN, INC. STREET 2: 1490 O'BRIEN DRIVE, SUITE A CITY: MENLO PARK STATE: CA ZIP: 94025 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 0001390798 McCamish Mark Anthony C/O FORTY SEVEN, INC. 1490 O'BRIEN DRIVE, SUITE A MENLO PARK CA 94025 1 1 0 0 President and CEO Common Stock 2020-03-16 5 G 0 E 60719 0.00 D 0 D Common Stock 2020-04-01 4 M 0 30237 4.8825 A 37172 D Common Stock 2020-04-01 4 S 0 2340 95.4138 D 34832 D Common Stock 2020-04-01 4 S 0 30237 95.4207 D 4595 D Stock Option (right to buy) 4.8825 2020-04-01 4 M 0 30210 0.00 D 2027-06-07 Common Stock 30210 314395 D Stock Option (right to buy) 4.8825 2020-04-01 4 M 0 27 0.00 D 2027-08-14 Common Stock 27 134629 D Includes 6,935 shares acquired under the Forty Seven, Inc. 2018 Employee Stock Purchase Plan. 96,773 shares subject to the option vested on May 1, 2018 and the balance of the shares subject to the option vest in a series of 36 successive equal monthly installments beginning June 1, 2018, subject to the Reporting Person's continuous service as of each such date. The shares subject to the option vest in a series of 48 successive equal monthly installments beginning August 15, 2017, subject to the Reporting Person's continuous service as of each such date. The shares subject to this option may be exercised prior to vesting, subject to the Issuer's right to repurchase. /s/ John T. McKenna, Attorney-in-Fact for Mark A. McCamish 2020-04-03