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